In the past few weeks we had a vivid look at what lies ahead for American health care should the Reid-Pelosi legislation be enacted. And it is worth some serious attention. In response to new guidelines on mammogram screenings announced by the U.S. Public Health Services own task force – guidelines that so horrified the American public – the Senate has already quickly had to amend its proposed bill to require that insurance companies provide mammogram coverage. 

       This illustrates what a tangled web of legislative and administrative directives would guide our health care pitting various conditions as well as generations against one another. The regulations and tax implications are set to become so unwieldy and complex that many businesses and individuals would have no hope of complying. This sets up a clear danger of selective enforcement which, though still unthinkable to most of us in America, could be used for sinister political purpose. (Perhaps several of the GM auto dealers forced to shut down might want to comment.)

        The U.S. Preventative Services Task Force (USPSTF) was set up in 1984 to evaluate the benefits of medical services and recommend which should become routine. It is a high level group made up of physicians, public health professionals and academics. Generally, while its work may be known in the medical world, it goes unnoticed to the general public. But its new mammogram guidelines really hit a nerve. For years the American public has been bombarded with information about breast cancer with emphasis on self-examination and the importance of getting mammograms. And most of us have been closely touched by breast cancer. Yet, there’s been a lot of good news – early detection, new treatments, and an ever-increasing survival rate. So how are we to react when being told we no longer need to examine ourselves and that we can put off getting tested for years? Rightly outraged. Many have worked for years to insure that all women could get mammograms especially low-income and black women who are at highest risk only to have it all reversed.

          Yet the USPSTF could be right too – although it’s puzzling why they might seem to fluff off what should really be the frontline of health: one’s own personal observations and concerns with one’s own body. Maybe every woman doesn’t need to get mammograms from age 40 or, without other risk factors, not need the annual test. But what this really illustrates is what health care is about – each of us and our individual needs. One size, one test, and one kind of treatment definitely does not fit all. And, which is why most of us still want our health care to be handled by ourselves and our doctors, not by bureaucrats, attorneys or accountants, and – most certainly not – by the U.S. Congress.