nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Thursday, July 15, 2010

The Preventive Is The Political Under HCR

 
Back in the Sixties, radicals would say, "The personal IS the political," implying that every thought and act has political implications. 

Mostly it was a way to compel conformity to a particular political philosophy:  there is no personal life, you have to be on board politically in everything you do.

Now prevention in health care is the political.

The US Preventive Services Task Force is a volunteer body of public health and medical experts who winnow the data on disease and injury to decide criteria for preventive medicine:  at what age should colonoscopy be performed, when should vaccines be given, what are the risk factors that indicate a treadmill?

Their signature publication, The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force, has been the authority on prevention in the US.  Not that there haven't been controversies over specific recommendations over the years.  The question of what age to begin mammography became a media firestorm just last year.  But in general, you could say that their recommendations represented the best of what we currently know in the science of public health.

That may be changing (Kaiser Hlth News & WaPo, July 15).
"Under the new health care overhaul law, insurers will be required to pay fully for services that get an "A" or "B" recommendation from the U.S. Preventive Services Task Force, ...[which] puts the group in the crosshairs of lobbyists and disease advocates eager to see their top priorities – including routine screening for Alzheimer’s disease, domestic violence, diabetes or HIV – become covered services."
As an example the American Diabetes Association lobbied successfully to include a requirement in the HCR law that "the task force include in its reviews of evidence the guidelines drafted by specialty groups, language intended to help preserve diabetes coverage."

Thus, this special interest group gets power over the Task Force's recommendations.  Where the science is not clear, the ADA will argue for coverage...and likely will get their way.

Statements by the Task Force that the science will come first, have already led lobbyists to engage directly with HHS, according the Washington Post, to get their special interest group desires covered.

Talk about a food fight.

And if many of these groups get their way, it's expected to raise everyone's insurance premiums.

Clearly the preventive is the political.

Doc D
 

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