In case you weren’t convinced that the government is spending millions of dollars on health care that does nothing to improve outcomes, this stat may change your mind: an investigation conducted by iWatch finds that “40 percent of Medicare spending on common preventive screenings [is] regarded as medically unnecessary.” Beneficiaries are receiving these tests “more frequently than medically recommended or at times when they cannot gain any proven medical benefit, extracting an enormous financial toll on the nation’s health care system.” This is because “doctors disregard scientific guidelines out of ignorance, fear of malpractice suits or for financial gain, as patients inundated by medical advertising clamor for extra tests.” The Affordable Care Act tries to tackle this waste by changing the incentives that lead to unnecessary care, funding tort reform demonstration projects, and investing in comparative effectiveness research to weed out ineffective treatments.

Last night, the Institute of Medicine (IOM) released its recommendations to the Department of Health and Human Services for defining essential health benefits — the standard benefits insurers will have to offer beginning in 2014. As Sarah Kliff explains, the institute had to balance “affordability against comprehensiveness,” find a way to please patient advocacy groups who “want to ensure that the benefit package is comprehensive, providing robust coverage for a wide array of medical conditions,” and industry groups who “worry that a sweeping benefit package could prove unaffordable.” Ultimately, IOM didn’t provide HHS with specifics, but offered a framework that erred on the side of affordability: it recommended that HHS model the package on the more modest benefits offered by small businesses to ensure that everyone can access the basic plan and that the central purpose of the Affordable Care Act is realized.

But Republicans — who have offered to deregulate the insurance industry almost entirely — are already speaking out against the recommendation. Sen. Mike Enzi (R-WY) offered this condemnation:

Small businesses can’t sustain these increases, especially when combined with the increases that will inevitably result from the more expensive essential health benefits packages mandated by the new law,” said Senator Enzi. “Employers need flexibility when determining what type of health insurance to provide their employees, so they can afford to continue offering coverage. Too many small businesses are already running the numbers and deciding they can’t afford to make payroll and pay for health care. The number of small businesses offering coverage decreased 11 percent this year, and rigid benefit packages will make this even worse.” [...]

“It is simple math that as more mandated benefits are included, the higher the costs will be,” Senator Enzi said. “As more regulations are published and more requirements are enacted, premiums will continue to increase which will likely lead to more small employers dropping coverage.

The purpose of the essential benefit rules, however, isn’t to burden businesses or individuals with new costs or unnecessary and unproven benefits, but to establish a floor of basic coverage that will allow companies to compete on cost rather than quality and guarantee that the most vulnerable parts of the population have access to the basic care they need. Beneficiaries will determine how much they pay for their benefits — insurers will offer bronze, silver, gold or platinum plans that will cover a certain percentage of the cost — but all new policies will provide comprehensive coverage and preventive care that is essential to maintaining good health. That’s a far cry from the deregulated markets that Republicans are proposing — in which insurers sell subprime policies that beneficiaries can never count on if they actually fall ill. That kind of coverage may be cheaper, but it’s also worthless for maintaining health and treating major disease.

With her poll numbers down after the entrance of Rick Perry into the GOP presidential race, Rep. Michele Bachmann (R-MN) is shifting her campaign message from a focus on the economy to the social issues that first launched her political career. In multiple town halls in Iowa this week, Bachmann reminded supporters that “as much as this election will be about jobs,” “we can’t forget the undergirding of our nation and those are the values, the principles that we stand for.” She urged voters not to “settle” on a candidate who lacks a track record of defending traditional social issues and reviewed her own accomplishments — from championing a constitutional amendment against same-sex marriage as a state senator in Minnesota to advocating anti-abortion legislation in Congress.

“As president I want you to know I’ll fight for life and for marriage, because we can have a president who believes in the power of prayer,” Bachmann says in a new video, “a president who is steadfast on the values of life, of marriage, and faith and with your support for my candidacy for the president of the United States, this will be the year conservatives don’t have to settle.” Yesterday, Bachmann went even further, announcing that she would sponsor The Heartbeat Informed Consent Act, “a bill in Congress that seemed aimed directly at evangelical voters.” The measure would require all abortion providers “make the heartbeat of the unborn child visible and audible to its mother as part of her informed consent.” From Bachmann’s statement:

“A pregnant woman who enters an abortion clinic is faced with a decision that will forever change two lives. That’s why she must have the very best information with which to make that decision. The ‘Heartbeat Informed Consent Act,’ that I introduced today, would require that abortion providers make the unborn child’s heartbeat visible through ultrasound, describe the cardiac activity, and make the baby’s heartbeat audible, if the child is old enough for it to be detectable.

“A study by Focus on the Family found that when women who were undecided about having an abortion were shown an ultrasound image of the baby, 78% chose life. An unborn baby’s heartbeat can be detected as early as five weeks after conception and ultrasound technology is an amazing medical advance that provides a window for a pregnant woman to see her unborn child. My legislation will not only enable this technology to be better used to protect life, but also to ensure that a woman who is considering abortion is finally able to give full and informed consent.”

Bachmann’s support for federally-mandated ultrasounds undermines her strong opposition to government requirements in health care. Her bill would institute an onerous bureaucratic regulation that inserts the government into medical decision making and creates another level of unnecessary federal regulation. As the Guttmacher Institute explains, every state already “requires that a patient consent before undergoing medical treatment” and provides adequate and appropriate information about the procedure. Bachmann is seeking even greater federal intervention and is relying on government regulations to talk women out of undergoing a medical procedure — a decision that is best left to the woman and her doctor. Six states currently mandate “that an abortion provider perform an ultrasound on each woman seeking an abortion, and require the provider to offer the woman the opportunity to view the image.”

Bachmann’s new-found emphasis on social issues is not without risk, the Associated Press notes. “[P]revious candidates boosted by Iowa’s evangelical voters have failed to capitalize on that success once the campaign left the state” and voters seem especially uninterested in the message in 2012. A recent ABC News/Washington Post poll found that just 3 percent of Republican respondents said social issues were the most important issue affecting their vote.