Rhetoric vs. Reality on Preventive Care
The Wall Street Journal has an article out this morning about an Administration event today releasing new rules for free preventive screenings. But even as the White House attempts to trumpet the possibility of additional preventive screening measures, it’s worth examining the record and writings of Don Berwick, whom President Obama appointed to head the Centers for Medicare and Medicaid Services (CMS) without Senate approval. From 1990 through 1996, Dr. Berwick served as the Vice Chair of the U.S. Preventive Services Task Force – a group which the article notes “drew criticism last year for recommending that women delay annual mammogram services until age 50, instead of age 40.”
Dr. Berwick spent much of his professional career engaging in cost-effectiveness analysis of preventive measures – including a 1985 Journal of the American Medical Association article on screening at health fairs, another 1985 article subtitled “Willingness To Pay for Ultrasound in Normal Pregnancy,” and a 1982 New England Journal article on “Cost Effectiveness of Lead Screening.” And in these and other writings and speeches, he has called preventive care an “over-demanded service,” in part because he does not view some screening measures as being cost-effective.
So even as the Administration prepares for another press event intended to send the message that the health care overhaul will lead to MORE preventive screening, President Obama went around Congress to install as CMS Administrator an individual who has advocated for LESS preventive care. It’s another one of the many ways in which the rhetoric of the law’s supporters does not match the reality of the post-“reform” world.