THE TREATMENT DECEMBER 3, 2009
After nearly three days of deliberation, the Senate finally cast its first vote to pass the Mikulski amendment to provide for women’s preventative services. The amendment, which passed 61-39, would prohibit insurance companies from charging co-pays for a range of women’s preventative services as decided by an HHS agency. While the unamended reform bill would have covered most preventative services with little to no cost-sharing, it wouldn’t have necessarily included some services specific to women. Only three Republicans voted for Mikulski’s measure—Snowe, Collins, and, surprisingly enough, David Vitter.
Vitter had, in fact, successfully pushed for the adoption a second-degree amendment to Mikulski’s provision, which effectively invalidated the US Preventative Services Task Force’s controversial new mammogram findings by forbidding the government from drawing upon the November 2009 recs to enact any laws. In reality, Mikulski’s original amendment never would have relied on the USPSTF for guidance on women’s preventative measures anyway. But Vitter was clearly trying to make a point about the supposed dangers of government rationing. “After these recommendations generated such anger among the American people, there was a lot of talk in Congress about taking steps to correct this situation,” Vitter said in a press release. “[I] heard from a number of survivors who credited annual mammograms for the early detection of their breast cancer.”
Of course, it wasn’t only Republicans who were inveighing against the Task Force—Mikulski herself insisted that her amendment was meant to guarantee that women under 50 would be covered for mammograms, clearly criticizing the USPSTF by implication. But despite the Maryland Senator’s rhetoric, her original measure never contained specific prohibitions or recommendations for medical practice. Instead, it authorized a government agency to decide for itself what was sound based on ongoing, independent research and analysis. Vitter’s amendment, in contrast, chose to throw out a specific set of scientific findings simply because they weren’t popular or politically convenient at the time.
Yes, there’s widespread disagreement about the mammogram guidelines within the medical community itself, and the timing of the findings was politically inopportune, to say the least. Given such controversy, it certainly makes sense to examine the findings of a government task force more closely, as a House Energy and Commerce hearing did yesterday. But it’s disturbing to think that the federal government should go in and cherry-pick the scientific findings it wants to respect based on popular opinion and purely anecdotal evidence.