Fox News' fearmongering: Nonbinding cancer screening recommendations are rationing
Research ››› ››› JEREMY HOLDEN
Fox News' Dr. Marc Siegel fearmongered that recent recommendations that younger women get fewer cervical cancer screenings represented a precursor of government rationing under health care reform. In fact, the guidelines, issued by a nongovernment medical organization, are the result of a medical review process reportedly initiated prior to the current health care debate and are not legally binding on insurers or health care providers.
Siegel claims cervical cancer guidelines are indicative of government rationing under health care reform
Siegel: "[H]ealth choices commissioner" will use "guidelines like this to tell insurance companies not to cover pap tests." During the November 20 edition of Fox News' America's Newsroom, Siegel responded to co-host Alisyn Camerota's question about recent guidelines from the American College of Obstetricians and Gynecologists (ACOG) and stated, "[A]s we go forward with health reform, we're going to see more and more mandates, more and more commissioners, more and more committees that are going to have to look to guidelines to decide what insurance can cover." He further claimed, "I don't know if we're getting a health choices commissioner or not, but if we are, that person is going to be using guidelines like this to tell insurance companies not to cover pap tests."
ACOG guidelines not binding and in no way connected to health care reform
ACOG issued nonbinding guidelines, not mandates. On November 20, ACOG announced new recommendations for cervical cancer screenings, stating: "Women should have their first cervical cancer screening at age 21 and can be rescreened less frequently than previously recommended, according to newly revised evidence-based guidelines issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the December issue of Obstetrics & Gynecology. Most women younger than 30 should undergo cervical screening once every two years instead of annually, and those age 30 and older can be rescreened once every three years."
ACOG: "[A] private, voluntary, nonprofit membership organization." The American College of Obstetricians and Gynecologists is not a government entity; it is a private membership organization. From the organization's website:
Founded in 1951 in Chicago, Illinois, ACOG has over 52,000 members and is the nation's leading group of professionals providing health care for women. Now based in Washington, DC, it is a private, voluntary, nonprofit membership organization.
ACOG works primarily in four areas:
- Serving as a strong advocate for quality health care for women.
- Maintaining the highest standards of clinical practice and continuing education for its members.
- Promoting patient education and stimulating patient understanding of and involvement in medical care.
- Increasing awareness among its members and the public of the changing issues facing women's health care. [ACOG website]
NY Times: "It is by no means clear that doctors or patients will follow the new guidelines." Further undermining Siegel's attempt to connect the ACOG guidance with health care reform, a November 20 New York Times article reported: "It is by no means clear that doctors or patients will follow the new guidelines. Medical groups, including the American Cancer Society, have been suggesting for years that women with repeated normal Pap tests could begin to have the test less frequently, but many have gone on to have them year after year anyway."
Recommendations reportedly "in the works for several years, 'long before the Obama health plan came into existence.' " Notwithstanding Siegel's efforts, the updated guidelines are in no way connected to President Obama or health care reform. The New York Times article reported, "Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians' group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, 'long before the Obama health plan came into existence.' "
Senate bill does not require insurers to adopt task force recommendations against preventive screenings, only those in favor of preventive screenings. The Senate health care reform bill, the Patient Protection and Affordable Care Act, requires insurance companies only to cover screenings that the United States Preventive Services Task Force recommends, those rated as an A or B recommendation; it does not require insurers to adopt guidelines that recommend against preventive screenings:
SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
(a) IN GENERAL. -- A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for --
(1) evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force
House bill requires insurers to adopt task force recommendations for coverage, but not those against coverage. Similarly, the House health care reform bill, the Affordable Health Care for America Act, requires insurance companies to cover the A or B recommendations of a new task force, the Task Force on Clinical Preventive Services, but does not require that insurers adopt recommendations against preventive services:
SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO ENCOURAGE WELLNESS AND HEALTHY BEHAVIORS.
(c) INCLUSION IN ESSENTIAL BENEFITS PACKAGE. -- If, on the basis of the findings of research and demonstration projects under subsection (a) or other sources consistent with section 3131, the Task Force on Clinical Preventive Services determines that a subsidy or reward meets the Task Force's standards for a grade A or B, the Secretary shall ensure that the subsidy or reward is included in the essential benefits package under section 222.
Media conservatives -- including Siegel -- previously fearmongered that nonbinding mammogram recommendations represented government rationing
Conservatives fearmonger that breast cancer screening recommendations foreshadowed government rationing. In the aftermath of the U.S. Preventive Services Task Force recommendation that women receive fewer breast cancer screenings, media conservatives have fearmongered that the nonbinding recommendations represent government rationing -- with some tying the guidelines to the debunked "death panel" smear. Siegel himself appeared on Fox News to claim that the recommendations were "absolutely" about health care reform, adding, "[T]his kind of health reform is not what we need." In fact, the task force recommendations are not legally binding, and the claim is undermined by the fact that the task force previously recommended against certain preventive cancer screenings under President Bush.