STEVE INSKEEP, host:
President Obama's administration was not dealing with the scientific pros and cons of mammograms, yesterday, because instead it had to deal with political damage control.
Here's NPR national political correspondent Mara Liasson.
MARA LIASSON: The mammogram study couldn't have come at a more inconvenient moment - just days before the Senate is taking up a health care bill the Democrats don't yet have the votes to pass. Republicans said the study reinforced their nightmare scenario about health care rationing.
And to make matters worse, they study was about the emotional issue of breast cancer � the number one health care concern for American women, according to polling done by Bob Blendon of Harvard University.
Mr. BOB BLENDON (Harvard University): The study clearly creates a political problem, because it raises doubts among many women about what reform would mean in an area they deeply care about and feel that they and their physicians need some discretion.
LIASSON: For Republican Congressman Dave Camp of Michigan, the mammogram study was the best weapon Republicans could have.
Representative DAVE CAMP (Republican, Michigan): This is the preview of what the movie's going to look like if the Pelosi health care plan or the Obama health care plan passes.
LIASSON: The Democrats' health care bills all create a marketplace or exchange where people could go to buy health insurance. The government would rely on independent taskforces � including the one that issued the breast cancer screening recommendations � to help determine what prevention benefits insurers in the exchange would have to offer.
To Camp, the task force's recommendations for fewer annual mammograms was a much more effective way to make his argument about rationing than the hyperbolic complaints about death panels heard at town hall meetings last summer - which, in Camp's view, were not very helpful to Republicans.
Rep. CAMP: Some people discounted the idea that the government would actually put people to death. And this actually is really showing how the insidious encroachment of government between the patient and their doctor plays out. And it's not a pretty sight.
LIASSON: And a group of Republican congresswomen, including Jean Schmidt of Ohio, held a press conference on Capitol Hill, Wednesday, to warn that access to mammograms could be restricted.
Representative JEAN SCHMIDT (Republican, Ohio): That's why I was so outraged by it. Right now, every year I'm allowed to have a mammogram, because that's what the recommendations are. My fear is it'll be every two years, and then maybe every three years.
LIASSON: To counter these arguments, Health and Human Services Secretary Kathleen Sebelius issued a statement saying women should keep doing what they've been doing for years. And in an interview with NPR, yesterday, she offered this reassurance:
Secretary KATHLEEN SEBELIUS (Department of Health and Human Services): Medicare will continue to pay for mammography services. Medicaid will continue to pay for mammography services.
LIASSON: And she went even further. In answer to the Republican charge that if a health care bill passes, task-force studies like the breast cancer recommendations would be the basis for restricting coverage on the health care exchanges, Sebelius pointed out that it's the secretary of Health and Human Services � not the advisory panels � who would be the final arbiter of what is and isn't covered.
Would you be willing to pledge, as long as you are the secretary of Health and Human Services, that you will make sure that every plan offered on the exchange will give coverage for annual mammograms for women over 40?
Sec. SEBELIUS: Well, yes. I think that is an important service. It's a determination that we've made.
LIASSON: The firestorm over breast cancer screening is just one example of why reforming the health care system is so difficult. And, says Bob Blendon, there will be many more arguments like this one, as Congress struggles with how to provide higher-quality, lower-cost health care for everyone.
Mr. BLENDON: The Congress and the president has put hundreds of millions of dollars in the studies which will look at the effectiveness of major treatments, preventive approaches that are currently being used today to see if they're both effective, and if there are less-costly ways of treating the same problem. And then they're going to have panels that come out with recommendations based on the scientific studies.
LIASSON: And many of those recommendations could involve changing the kind and quantity of health services Americans have come to expect.
Mara Liasson, NPR News, Washington.
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