Are you familiar with Mammogram testing? Probably you are.
Mammogram testing began in 1976. Since 1997, the American Cancer Society (ACS) has recommended annual mammogram testing for all women over the age of 40.
– Reference (1) at bottom.
You are also probably aware that the subject of Mammogram testing has just exploded, controversially, into the already heated debate on national healthcare.
“On Monday, Nov. 16, USPSTF announced that [it] was changing long-standing mammography guidelines and would no longer recommend routine, annual mammograms for women between the ages of 40 and 49. ”
– Reference (2) at bottom.
Like most controversies, there are two objective, arguable sides to this issue; due to the fact of false positives (the test can give the wrong answer, and unnecessarily frighten and inconvenience women and their families); however, like most issues related to healthcare (aka ObamaCare), disingenuousness has clouded the discussion.
Whose disingenuousness? HHS Secretary, Kathleen Sebelius.
Webster's New World College Dictionary, 4th Ed. provides the following definitions: 1. not straightforward; not candid or frank; insincere, 2. slyly deceptive or misleading, typically by means of a pretense of ignorance or unawareness.
Disingenuousness is the most subtle of all human, intentional deceptions. Did you know that the Bible teaches us about disingenuousness? The word disingenuous is not found in the Bible, so you have to reflect on exactly what the purpose of disingenuousness is: To intentionally deceive someone else, without actually saying anything that could be easily and positively identified as a lie. In other words, it is a pretense. In the Bible, we find this deception employed by people identified by Jesus as hypocrites:
“["Woe to you, scribes and Pharisees, hypocrites, because you devour widows' houses, and for a pretense [emphasis mine] you make long prayers; therefore you will receive greater condemnation.]”
– Matthew 23:14 [NASB]
Obama's HHS ([United States Department of] Health and Human Services) Secretary, Kathleen Sebelius told American women on November 18, 2009 not to worry about a government advisory panel changing guidelines on breast cancer screening:
“[November 19, 2009] You've heard about those changing guidelines on breast cancer screening issued by a government advisory panel? Never mind, said Health and Human Services Secretary Kathleen Sebelius on Wednesday.
Amid an outcry from confused, angry women and physicians -- even the American Cancer Society objected to the changes -- Sebelius issued a statement Wednesday basically telling women to ignore what the U.S. Preventive Services Task Force had said [emphasis mine]. The USPSTF advises HHS, and its members are appointed by HHS.
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"The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government. [emphasis mine]”
– Reference (3) at bottom.
If your instincts have guided you in the direction of never trusting any pronouncement made by Obama or by one of his apparatchiks, your instincts are spot-on and functioning properly. While it would be a stretch to label Sebelius's pronouncement a lie, her pronouncement is definitely disingenuous.
The disingenuousness at issue is the influence of the U.S. Preventive Services Task Force (USPSTF). The USPSTF advises HHS, and its members are appointed by HHS. This means that they have a close working relationship. Who, in their right pragmatic mind, can imagine that HHS is not going to be greatly influenced by what USPSTF recommends?
Furthermore, Congress has given USPSTF an official link to CMS (Centers for Medicare and Medicaid Services) which is a sub-agency under HHS.
"The Medicare Improvements for Patients and Providers Act of 2008 ( MIPPA ) gave CMS the ability to consider whether Medicare should cover "additional preventive services," if certain requirements are met."
– Reference (4) at bottom.
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"Under MIPPA, CMS can consider whether Medicare should cover preventive services that Congress has not already deemed as covered or non-covered by law, as long as they have been "strongly recommended" or "recommended" by the U.S. Preventive Services Task Force. For instance, the Task Force graded HIV screening as "strongly recommended.""
– Reference (5) at bottom.
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"Congress recently expanded Medicare’s ability to cover preventive services that are recommended by the U.S. Preventive Services Task Force. CMS will use its National Coverage Determination (NCDs) process to review preventive services, and may – for the first time – explicitly consider cost-effectiveness as a criterion for coverage."
– Reference (6) at bottom.
Furthermore, Nancy Pelosi's latest monstrosity of ObamaCare, the unaffordable, so-called AFFORDABLE HEALTH CARE FOR AMERICA ACT, H.R. 3962, if enacted into law would grant USPSTF even more power:
"U.S. Preventive Services Task Force (USPSTF) – converts the USPSTF into the Task Force on Clinical Prevention Services. Staffed by the Agency for Healthcare Research and Quality (AHRQ), non-governmental experts will conduct evidence-based systematic reviews of data and literature to determine which clinical preventive services are scientifically proven to be effective [Jerry's comment: And of course which ones, in their opinion, are not]."
– Reference (7) at bottom.
So let's take Kathleen Sebelius' statement, "The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government." and examine it clause by clause:
The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. TRUE
They do not set federal policy TRUE
and they don’t determine what services are covered by the federal government." DISINGENUOUS.
"Under MIPPA, CMS can consider...as long as they have been "strongly recommended" or "recommended" by the U.S. Preventive Services Task Force.
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"...converts the USPSTF into the Task Force on Clinical Prevention Services."
In other words, USPSTF recommendations will determine what CMS can and cannot consider that is not already covered by law.
And if an ObamaCare bill becomes law that converts the USPSTF into the Task Force on Clinical Prevention Services, then of course it would have power not only with Medicare/Medicaid, but with all ObamaCare. It's anybody's guess as to how much power this Task Force would actually wield.
If you are wondering about a possible motive for Sebelius's disingenuousness, try on for size the thought of not raising the specter of Palin's “death panel”. Actually, it was the legislative proposals of "Advance Care Planning Consultation” that triggered Sarah Palin's controversial metaphor of a "death panel".
However, the notion of a group of government-connected "experts" dictating one-size-fits-all, life-and-death medical decisions via who-gets prevention services is scary, especially when it is based upon the statistics of large categories such as an entire age group. This sort of medical decision-making contains the crux notion of a "death panel", whatever name you prefer to give it.
For me, I prefer that my family doctor (undictated-to and unpressured-by outside agents), in consultation with me (as the final decision maker in consultation with God and family), decide whether and when prevention services are in my best interest. And I would appreciate it if Obama, all the Obamabots, and the aficionados of ObamaCare would just keep their grubby, socialistic paws off what little freedom I still have left with my healthcare.
I do understand why Sebelius would be reluctant to get into such a nuanced discussion, but portraying the USPSTF as if they are an organization that can simply be "ignored" by American citizens is not an honest message. Disingenuous? Yes.
FOOTNOTES:
(1) Chronological History of ACS Recommendations on Early Detection of Cancer
(2) HHS Secretary Says Never Mind Those New Breast Cancer Screening Guidelines Made By an HHS Advisory Panel
(3) Ibid
(4) HIV Screening Proposed for Medicare's Covered Preventive Services
(5) HIV Screening Tests Proposed to Be Added to Medicare`s List of Covered Preventive Services
(6) Web-Based Audio Conference on Medicare and Preventive Health Services
(7) HIGHLIGHTS OF THE HOUSE MERGED HEALTH CARE REFORM BILL – “AFFORDABLE HEALTH CARE FOR AMERICA ACT”, H.R. 3962
