When gov’t runs healthcare, it’s always about cost

This morning I was reminded again why government-run healthcare is so insidious.

A new debate has transpired over the use of CT scans to detect lung cancer. Not surprisingly, the dispute was triggered by a federal study, which found that screening “certain heavy smokers and ex-smokers” could greatly reduce their mortality rate.

Supporters of the exams promote the benefits and argue that insurance companies ought to cover the expense, while opponents claim it’s not clear the “benefits will outweigh the risks.” They worry an increase in CT exams will spark a series of perhaps unnecessary — and costly — follow-up tests and medical procedures.

This debate immediately brings back memories of the U.S. Preventive Services Task Force’s 2009 recommendations that women in their 40s should not have annual mammograms and older women should reduce their use of the service as well.

At the time, the panel considered the number of false positives and unnecessary follow-up procedures against the number of lives saved from early detection. It claimed screening women earlier would only prevent 0.7 breast cancer deaths per 1,000 women, while an additional 470 women would receive false positives and another 33 would undergo needless biopsies.

In the case of CT screenings, it’s not overwhelmingly clear that the benefits outweigh the risks. (And I think we often underestimate the emotional strains placed on patients who have to undergo superfluous exams.) Still, as my IWF colleague Carrie Lukas has written, determining who’s right is “a matter of perspective.” Whether we’re talking about screening for breast, prostate or lung cancer, ultimately only individuals — with the help of their doctors and families — can make these decisions.

Some individuals will choose to avoid uncomfortable, expensive procedures, while others will consider their medical and family history and see the benefit in more aggressive screening. Ultimately, individuals should be made aware of both risks and benefits so they can make an informed decision.

But as government’s role in healthcare has grown, the question is no longer simply one of false positives versus early detection. With the decision over the individual mandate looming large, cost is a significant factor in all of these debates. This was the case with the fight over mammograms, and it’s an obvious factor in this debate, in which supporters of increased CT screening want insurance companies to be required to cover the service.

As I’ve written here before, a healthcare system that mandates health insurance companies to provide a good or service for everyone — no matter how (un)necessary — is unsustainable. By pushing for universal coverage of specific procedures or services, we simply ensure higher costs and fewer choices.

That’s why the public should reject a one-size-fits all healthcare system, in which a federal panel rather than a patient determines risk and makes life-saving decisions. We should work to roll back ObamaCare and advance a healthcare marketplace in which patients shop for policies that best serve their individual needs and preferences.


Sabrina L. Schaeffer is a senior fellow with the Independent Women’s Forum and managing partner of Evolving Strategies.