Senator's Column

November 30, 2009 Preventive Measures a Necessity in Health Care Coverage

by Mike Johanns

Dear Nebraskans, When the federal government promises to provide more for less, red flags rightly go up. This has been part of the health care reform debate. How can the government provide health insurance to tens of millions more people without skyrocketing costs, a decrease in services, or both? It simply cannot. Therefore, it begins to make decisions based on cost instead of what is best for patients. Even preventive and early diagnosis tools-the importance of which have been heavily touted by this Administration-could be scaled back.

The U.S. Preventive Services Task Force, an advisory committee within the Department of Health and Human Services (DHHS), revised its recommendations for using mammography as a tool to combat breast cancer. The Task Force's recommendations now advise against the use of routine mammogram screening for women under 50 years of age.

The poor judgment of the Task Force has been criticized by numerous highly-respected organizations. Let's just start with the basic facts: approximately 17 percent of breast cancer deaths occur among women in their 40s, yet since regular mammogram screenings were adopted in the 1990s, the mortality rate from breast cancer has dropped an astounding 30 percent. The effectiveness of mammogram screenings in combating one of our country's deadliest diseases cannot be overstated. Since the Task Force's announcement, the American Cancer Society, the breast center at Johns Hopkins, and the American College of Radiology have all publicly stated the importance of continuing mammogram screenings for women in their 40s. The Mayo Clinic asserted they find "invasive breast cancer" in women in their 40s "every day."

Preventive health care services are a mandated benefit under the current health care bills before Congress. The legislative text outlines that the standard for preventive health care will be determined by the recommendations of the Task Force. In fact, in the current Senate bill, the Task Force is referenced 14 times. That is why the new guidelines are so troubling; they showcase how the government can truly set policy and make decisions that come between patients and their doctors-all in the name of controlling costs.

It is important that health care reform does not decrease the quality of care within our current system. Reform is supposed to make things better, not worse. Even President Obama in September insisted upon the inclusion of mammogram screenings, "because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse." I agree, and have sent a letter to Secretary Sebelius saying as much. I will continue working to see that the attempt to reform our health care system does not eliminate procedures that save lives.