The Agency to Run Your Life

by Benjamin Domenech on 6:59 pm October 7, 2010


One of the troublesome things about living in the brave new health care world is keeping track of all the bodies that, thanks to President Barack Obama, have new powers to govern your daily life. For instance, have you heard about the United States Preventive Services Task Force? No? Well, they’ve heard of you, and they’ve already got some plans. Don’t worry—you’ll know what they entail soon enough.

Even at 3,000 pages, much of President Obama’s health care law is very vague—it’s more about assigning authority for making decisions than anything else. And as of September 23, a great deal of that authority now rests with the USPSTF. It’s a federal advisory committee made up of 16 volunteers.

Under Obama’s law, all health insurance plans must now cover nearly all the services recommended by the USPSTF. Essentially, those 16 unelected bureaucrats will make recommendations that were previously more like guidelines but are now mandatory.

Under this new scenario, we face a double-edged sword on mandated coverage. Private insurers won’t be able to account for the costs of newly recommended services—driving up premium costs by inclusion of government-mandated preventive care people may not need—while Medicare denies payment for prevention services the Task Force recommends against—even if people do need those services.

Obama’s law requires the USPSTF to consider cost as a factor in making all sorts of recommendations—they’ve only considered your health in the past—and if they follow that guideline, expect more services to go uncovered. Their work also could lead to huge administrative nightmares for insurers—such as mandating that plans must cover preventive services for an African-American woman but not her Caucasian husband, even though they both hold the same insurance policy.

What’s more, the USPSTF is going to make these recommendations without being subject to the Federal Advisory Committee Act. The FACA was intended to give the public the ability to access the hearings and processes behind the major decisions of advisory committees like this one. But through a legal loophole, the USPSTF is exempt.

Operating in the shadows of what was sold to us as the most transparent administration in history, it’s inevitable that interest groups will lobby members of the USPSTF to recommend certain types of screenings that require the use of a certain drug or medical device—a back door to millions in profit through old-fashioned political manipulation.

Worst of all, there is no limit to the number of recommendations the USPSTF can make each year. Last fall the USPSTF recommended against covering mammograms for some women, who the task force said didn’t need the coverage, causing blowback from breast cancer groups. Imagine that scenario playing out every year with new and confusing recommendations from an unelected body, now made mandatory under Obama’s health regime.

That’s just one of the unelected groups that will affect your health care. Today, at the federal level alone, there are more than 1,000 of these advisory committees operating across all policy areas—volunteer bureaucrats who don’t have to stand for election, making decisions without having to defend them, governing Americans by fiat.

The public doesn’t want this. According to a Washington Post/ABC News poll earlier this year, 58 percent of Americans prefer smaller government, while only 38 percent want a larger government with more services. But this new health care regime takes us away from what most Americans want, with more power for unelected appointees to lord over the public, less transparency on the decisions they make, and more of your life run by Washington.

It’s the way of the future—unless we fight it.

Benjamin Domenech ( is a research fellow for the Heartland Institute and managing editor of Health Care News

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