Yesterday, I appeared on the Senate Doctors Show to ask Sen. John Barrasso (R-WY) about his recent claim that page 1190 of the Senate bill allows the Preventive Task Force “to decide what care is given and not given.” I read from page 1190 of the bill, pointing out that the Task Force does not have the power to mandate coverage.
Barrasso disputed my claim by arguing that the first line of page 1190 would prohibit the government from paying for preventative services that “has not received a grade of A, B, C, or I by such Task 5 Force”:
Watch the exchange (starts at 5:57):
So who’s right? Pages 1189 and 1190 of the Senate health care bill give the Secretary of Health and Human Services the authority, “if the Secretary determines appropriate,” to modify existing preventive care guidelines for Medicare and Medicaid only. If the Secretary chooses to modify the existing package of preventative services, the legislation instructs the Secretary to rely on scientific guidelines (instead of industry lobbyists, for instance). The bill specifically contradicts Barrasso’s claim that care or treatment would be rationed in lines 6-9 on page 1190. “Nothing in the amendment made by paragraph (1) shall be construed to affect the coverage of diagnostic or treatment services,” the bill states:
If the Secretary were to adopt the Task Force’s grade ‘C’ mammogram decision, the guideline would advise the doctor that the Task Force “recommends against routinely providing the service.” The recommendation stipulates that doctors should “offer or provide this service only if other considerations support the offering or providing the service in an individual patient.” In other words, providers like doctors Barrasso or Coburn, can use the recommendations as a starting point to examine a patient’s particular needs.
If the doctor decides that the patient needs the test, it will be paid for by Medicare. If the doctor relies on the recommendation and does not order a treatment, a patient would have to pay for her own mammogram. If that test is positive, lines 6-9 specifically state that cancer treatment would be fully covered. In short, the Task Force has no power to “decide what care is given and not given.”