Politico’s Patrick O’Connor reports that the biotech lobby is threatening to back Massachusetts Republican Scott Brown’s bid for Senate in a last-ditch effort to strengthen in its hand in the health-care negotiations:
In the first amendment offered on the opening day of the Senate health-care debate, Senator Barbara Mikulski proposed to restore a provision for women’s preventative services that had originally been in the Senate HELP bill.
It’s certainly been a big news week for lady parts, as some of my lady colleagues at TNR have pointed out today. But while the conservative fear-mongering about “government rationing” is an obvious political ploy, some vital questions about how much women will have to pay for preventative care in the Democratic health-care bill have yet to be resolved.
Reid’s merged Senate bill left out part of an amendment that Barbara Mikulski had successfully introduced into the Senate HELP legislation, which requires insurance companies to include women’s preventative services as part of all minimum benefit packages, for little or no cost. Mikulski argued that women of child-bearing age end up paying an average of 68 percent more in out-of-pocket costs, partly due to reproductive health needs, and often ended up delaying or forgoing care (like mammograms) because of the expense. The provision—which was in neither the House nor Finance Committee legislation—was slated to be in Reid’s bill this week, but “CBO decided at the last minute there was a problem and it was removed until that is resolved,” Mikulski spokesperson Rachel MacKnight said in an email today.
The problem, according to sources familiar with the issue, was that the Mikulski’s amendment wasn’t specific enough in terms of how it would determine which services would be covered, simply saying that it would be it up to the discretion of HHS to set the guidelines for coverage. As such, the provision was so broad that CBO ended up having to give it a very high—i.e. expensive—score, and Reid ended up leaving the language out of the bill.
Conservatives have already begun stoking fears that the new mammography recommendations that screenings should begin at 50 years instead of 40 will inevitably lead to “rationing,” particularly if Obama’s health-care reform bill passes. “I absolutely believe this could be a form of rationing," Representative Phil Gingrey told Fox News yesterday. “It scares me.” A private physician quoted in the story said the guidelines issued by the federal task force were “at the top of a slippery slope toward rationing,” claiming that “the government-run insurance companies are definitely going to be using these federal guidelines.”
But to what extent will recommendations from the U.S. Preventative Services Task Force actually dictate what’s covered under the new reform bill? Over at FireDogLake, Daniel Dayen flags the White House’s attempt to push back against the “rationing” meme. On the White House blog yesterday, Dan Pfeiffer explained why the government and insurers weren’t automatically going to adopt the task force’s findings:
The USPTF would have no power to deny insurance coverage in any way…They are an independent scientific body that makes recommendations based on scientific evidence; however they do not set official policy for the federal government. Under health reform, their recommendations would be used to identify preventive services that must be provided for little or no cost.
To clarify: in its effort to regulate the insurance market and expand preventative coverage, the health-care legislation would require insurance companies to provide a certain set of preventative services for free or at little cost, according to a minimum benefits package determined by the Department of Health and Human Services. Medical treatments outside of this prescribed set of preventative services could be subject to cost-sharing--i.e. a co-pay that the patient has to contribute--but would hardly be automatically excluded from coverage. As Dayen concludes, findings by the USPTF--an independent group compromised of medical authorities and primary-care experts--would serve as a guide for HHS to determine which treatments should be part of preventative services and which are subject to co-pays, but coverage is by no means limited to what the task force recommends.
The Clinton Tapes:
Wrestling History with
the President
By Taylor Branch
(Simon & Schuster, 707 pp., $35)
In her infamous first sentence of The Journalist and the Murderer, Janet Malcolm swings for the fences and proclaims that "every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible." She means that journalists use their human subjects and then dispose of them; that we con them in person by "preying on people's vanity, ignorance, or loneliness"--it occurs to me to note that however bleak print's future seems, journalism will at least never run out of material--before gutting them in print. This was a provocative thought in 1990, in those years of innocence before the Internet turned the guttings into a spectator sport.
Conservatives keep insisting that Obama and his allies want to force end-of-life planning on the elderly, so that it'll be easier to pull the plug on grandma when she gets sick. And the charge keeps sticking, even though the measure that conservatives are citing--section 1233 of the House health reform bill--does nothing of the sort.
