Quick Fact: Media repeat conservative claim that nonbinding health guidelines foreshadow rationing


In recent days, several media outlets have repeated the conservative claim that a task force recommending that fewer women younger than 50 receive regular mammograms is a precursor to government rationing under health care reform. In fact, the recommendations are not legally binding on health care providers or insurers.

Fox News, ABC, CNN repeat claim

Fox News' America's Newsroom: "Doctors say the new rules are an example of the kind of rationing we can expect from government-run health care." On the November 19 edition of Fox News' America's Newsroom, Alisyn Camerota stated:

CAMEROTA: There are controversial changes, as you all know, to mammogram guidelines out this week, leaving many women confused and even more doctors very upset: a government task force now recommending against annual screening for women in their 40s and mammograms only every other year for women in their 50s. Many doctors say the new rules are an example of the kind of rationing that we can expect from government-run health care.

ABC News' McKenzie equated recommendations to "countries with nationalized health care" then quoted doctor saying: "It's about the beginning of rationing care." On the November 18 edition of ABC's World News, correspondent John McKenzie reported:

McKENZIE: The new screening guidelines, created by an independent federal advisory panel of 16 health care professionals, concluded that, for most women, routine mammograms are not necessary in their 40s, and only every two years after that -- recommendations similar to those in Canada and most European countries with nationalized health care. That's why some doctors now question the panel's motives.

DR. PETER JOKICH (radiologist at Rush University Medical Center): I think it's totally ridiculous. I may not be politically correct, but I think this is really about money and politics. It's about the beginning of rationing care. And I don't think it's really about the health of individual women.

CNN's The Situation Room: Recommendations are a "sensitive political subject" for Dems seeking health care reform; "Republicans saying ... 'There's going to be rationing.' " On the November 18 edition of CNN's The Situation Room, host Wolf Blitzer stated:

BLITZER: Some Republican women in Congress are pouncing on the recommendations and raising red flags about health care rationing.


BLITZER: This, Gloria [Borger], is about a sensitive political subject right now for the president and for the Democrats in Congress who want to push through health care reform. And Republicans saying, "You know what? There's going to be rationing."

Fact: Task force recommendations not legally binding

Task force did not recommend blanket ban on mammograms for women under 50. The task force issued a grade C recommendation "against routine screening mammography in women aged 40 to 49 years" and stated that "[t]he decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms." As a grade C recommendation, clinicians are counseled to "[o]ffer or provide this service only if other considerations support the offering or providing the service in an individual patient."

Task force encouraged policymakers to include additional considerations and "individualize decision making to the specific patient or situation." In publishing its updated recommendations in The Annals of Internal Medicine, the task force acknowledged that other considerations should be included in determining what preventive treatment to provide, stating, "The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation."

NBC's Snyderman: "It's important to remember that these new recommendations from this independent task force are just that -- they're recommendations." In a Nightly News report on the task force recommendations, NBC chief medical correspondent Dr. Nancy Snyderman stated, "It's important to remember that these new recommendations from this independent task force are just that -- they're recommendations. They don't mandate any changes in who should get mammograms and when." [NBC's Nightly News with Brian Williams, 11/17/09]

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