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How the Low-Profile Mandate Committee Influences Your Medical Practice

By Stewart Gandolf, Chief Executive Officer

The opinion/editorial page in every publication draws fewer readers than the front page. Traditionally, the Op-Ed section is less interesting and exciting than the flash of hot news. So, in case you missed Dr. Scott Gottlieb’s opinion piece for the Wall Street Journal about healthcare’s Mandate Committee, it’s well worth two minutes of your time.

Not familiar with the so-called Mandate Committee?

Although everyone in the healthcare provider chain—from pharmaceutical industry to patients and providers—should be aware of the United States Preventative Services Task Force, it is “largely insulated from public view.” As the WSJ item describes it: “Under ObamaCare, a single committee—the United States Preventative Services Task Force—is empowered to evaluate preventive health services and decide which will be covered by health-insurance plans.”

Using a letter scale of A through D, the task force publishes grades for medical services such as cancer screenings and others. An A or B rating would require the service to be covered in full by health plans, but a letter grade of C or D would be excluded from coverage.

Dr. Gottlieb offers two examples for perspective. “Americans first became familiar with the task force in November 2009, when it made the controversial decision to recommend that women ages 40-49 shouldn't get routine mammograms. More recently, it rebuffed routine prostate-cancer screening and the use of tests that detect the viruses that can cause cervical cancer.”

Healthcare administrators, physicians and medical marketing professionals will need to track the information about recommendations. Among the consequences of the letter grade system is the expectation that “Health plans will inevitably choose to drop coverage for many services that don't get a passing grade from the task force and therefore aren't mandated.

“Insurance companies will need to conserve their premium money, which the government regulates, in order to spend it subsidizing those services that the task force requires them to cover in full.” Further, close communications and tracking is challenged by the system’s structure.

“The task force is a part-time board of volunteer advisers that works slowly and is often late to incorporate new science into its recommendations,” observes Dr. Gottlieb. Accordingly, advice can be out of sync with conventional medical practice and/or ignored by practicing doctors.

You’ll want to read the complete Wall Street Journal item titled, Meet the ObamaCare Mandate Committee. And you’re welcome to post your own opinion below.

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