February 16, 2012

“HHS Prohibited Panel Developing Contraception Mandate from Considering ‘Cost Effectiveness’”

Money is no object! Particularly when it isn’t yours!

And yet those with the Utopian impulse still seem mystified when their grand schemes crumble under the weight of both math and the individual’s refusal to be enslaved by the State.

CNS News:

There would be no consideration of cost effectiveness.

That was the explicit condition that the Department of Health and Human Services imposed on the panel of scientists it commissioned to develop the “preventive services” mandate that will require virtually all health-insurance plans in the United States to cover sterilizations and contraceptives—including those that cause abortions.

The fact that HHS prohibited the panel from considering the cost effectiveness of the mandate it developed sharply contrasts with President Obama’s declaration at the White House last Friday that his administration had adopted the panel’s recommendations precisely because they will “make the overall cost of health care lower”

Or, more simply put, the President lied.

One scientist who served on the panel, meanwhile, suggested in a dissenting opinion that the panel’s recommendations in fact might not be cost effective and that the panel’s process for arriving at its recommendations “tended to result in a mix of objective and subjective determinations filtered through a lens of advocacy.”


The panel—The Committee on Preventive Services for Women–had only 6 months to do its work and met only 5 times. On July 19, 2011, it issued a report with its recommendations. These included the following: “The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity.”

Less than two weeks later, on Aug. 1 of last year, HHS Secretary Kathleen Sebelius issued the panel’s contraception-sterilization recommendation as a new federal regulation—set to take effect on Aug. 1 of this year.

In its report, the committee had noted the short time in which it had to work and repeatedly reiterated HHS’s order that it could not consider cost effectiveness in determining its recommendations.

“The committee met five times within six months,” the report said.

“The cost-effectiveness of screening or services could not be a factor for the committee to consider in its analysis leading to its recommendations,” the report said.

“However, it should be noted that the committee did not have adequate time or resources to conduct its own meta-analyses or comprehensive systematic review of each preventive service,” the committee warned.

“Finally,” the committee said, “cost-effectiveness was explicitly excluded as a factor that the committee could use in developing recommendations, and so the committee process could not evaluate preventive services on that basis.”

“Furthermore,” the committee said, “for consistency in approach with the other three guidelines used by the ACA and given the time limitations for this study, the committee was restricted from considering cost-effectiveness in its process for identifying gaps in current recommendations.”

One of the 16 scientists on the panel—Prof. Anthony Lo Sasso a senior research scientist at the University of Illinois at Chicago’s School of Public Health–issued a dissenting report. He criticized the panel’s process for lack a rigorous analytical method and for filtering things “through a lens of advocacy.” He also suggested there was good reason to believe the panel’s recommendations might not be cost effective.

“Readers of the Report should be clear on the facts that the recommendations were made without high quality, systematic evidence of the preventive nature of the services considered,” Lo Sasso wrote. “Put differently, evidence that use of the services in question leads to lower rates of disability or disease and increased rates of well-being is generally absent.

“The view of this dissent,” wrote Lo Sasso, “is that the committee process for evaluation of the evidence lacked transparency and was largely subject to the preferences of the committee’s composition. Troublingly, the process tended to result in a mix of objective and subjective determinations filtered through the lends of advocacy. An abiding principle in the evaluation of the evidence and the recommendations put forth as a consequence should be transparency and strict objectivity, but the committee failed to demonstrate these principles in the Report.”

Lo Sasso also raised a question about the potential cost effectiveness of offering some preventive services for free because it would create a “benign moral hazard”—leading more people to utilize the free service.

“Whether coverage of preventive service leads to a reduction in healthcare expenditure depends on the fraction of enrollees using the service before the service becomes covered and the magnitude of the response among enrollees who experience the reduction in out-of-pocket price,” wrote Lo Sasso. “Knowing how elastic patient demand is to preventive services is a critical element to a coverage decision even if one already has good estimates of the effectiveness and cost-effectiveness. This is self-evidently a useful parameter to know for any preventive service because it highlights the impact that first-dollar coverage of the service will have, perhaps in relation to other forms of outreach.”

Because the committee was not given the time to do a serious analysis of the real impact of the recommended “preventive services,” Lo Sasso recommended that Secretary Sebelius not mandate the services “until such time as the evidence can be objectively and systematically evaluated.”

Despite the fact that this scientifically panel charged with coming up with the recommended preventive services had been expressly forbidden from looking at their cost effectiveness, President Obama declared that his administration had moved forward with the recommendations precisely because of their cost effectiveness.

Or, more simply put, the President lied.

The “science” marshaled here is no more than another postmodern effort to manufacture consent by providing a veneer of logic and study — all of which is intended to create an overall perception of rigor and considered analysis where none in fact took place.

Scientists, as envisioned by this Administration — and by the left more generally — are either willing advocates or useful idiots. Much like the Blue Dog Democrats the DNC uses to present moderation in order to win the majorities needed to ram through its progressive agenda.

So how ’bout it? Can we just say it, dodge the lightning strikes, and keep going? That the President lied? Or do we need to just keep pretending poor ol’ Barack is simply in over his head — a Good Man with good intentions, albeit with bad plans to bring those good intentions to fruition.

And yes, that was a rhetorical question.

Posted by Jeff G. @ 4:42pm

Comments (44)

  1. I still want to know whether the planned policy had been run by the Office of Legal Counsel before it was promulgated, in order to determine whether it was square with the Constitution, and whether, if it was so vetted, the Office of Legal Counsel produced a memo or report to that effect (that the policy is Constitutional). ‘Cause, I happen to think any lawyer attaching their name to such a finding will be laughed out of the guild within a year or so of such a revelation.

  2. On the formatting front: more block-quoting wanted on the CNS article.

  3. It’s extremely cost-effective to shoot people in the head when they get cancer or are born with cystic fibrosis.

    Never, never, never walk that “cost effectiveness” road when talking about collectivized healthcare, or suddenly all doctors are veterinarians and putting people down becomes the preferred method of dealing with chronic conditions.

  4. dicentra — that’s their dream, and you know it.

  5. There was another story — saw it on PJMedia, I think? — that the “board” that made the decision was entirely made up of pro-abort fanatics.

  6. The Obama “compromise” may have drawn on his life experiences for its creation.

    In Sharia-compliant lending the lender will buy the property at the selling price and then turn around and sell it to the buyer at the higher price which includes what would have been the total interest payments over the length of the loan. The extra amount over the price that the lender paid and the seller got is not called interest but is simply thought of as the price of the property and so the loan can be, wink-wink, considered a no interest loan.

    The Obama insurance compromise works the same way. They buy “X” but pay price “X+Y” and pretend that they didn’t pay for the forbidden “Y” because it was just a high priced “X”. Unlike the Sharia-complicit the Catholic Bishops and laity don’t think their God is such an idiot to be taken in by this ruse.

  7. How about he’s a very bad man who’s in over his head?

  8. Never, never, never walk that “cost effectiveness” road when talking about collectivized healthcare,

    That was how it was justified and it was a lie.

  9. The best way to bend the cost curve is to just start killing old people.

    / honest progressive

  10. ot my allan i was having pw withdrawals. god bless jeff g.

  11. The vast majority of the committee members demonstrate a more than casual commitment to the goals of the abortion lobby. In fact, according to information available from the public record, these committee members have donated a total of $116,500 to pro-choice organizations and candidates. Public records show that not one of the fifteen committee members has financially supported a pro-life political candidate. This committee was purportedly assembled for the purpose of providing outside, objective, and expert advice to the HHS policymakers. Whatever one thinks of the relevant issues, one would be hard-pressed to argue that this IOM committee is politically nonpartisan.


  12. ot @ nro

    In the Internet and blogosphere: Glenn Reynolds, Erick Erickson, Moe Lane, Leon Wolf, and the gang at Red State, Ed Morrissey, Jazz Shaw, Allahpundit and the Hot Air gang, Andrew Breitbart, Katie Pavelich, Tucker Carlson and the whole Daily Caller gang, Conn Carroll, Robert Stacy McCain, Kurt Schlichter, Guy Benson, Jeff Goldstein and the guys at Protein Wisdom,


  13. I’ll take back about 3½% of the nasty things I’ve said about Geraghty, though I’ll probably say more before the GOP convention. Of course there was never any doubt I’d re-subscribe to the Morning Jolt this fall…

  14. HTML entities for fraction symbols don’t seem to work. Dammit.

  15. Did anyone other than sdferr and myself have PW load up as a blank screen back around 7:45 mountain 9;45 eastern?

  16. yes

  17. Sorry, that was me fixing things. I fixed things a little too well…

  18. the fixter with the mixter

  19. A simple compare and contrast:

    The Hill

    The Washington Examiner

  20. Better too well than not at all. Thank you Pixy Misa.

  21. It is sort cool to see Pixy Misa. Not mythical.

    Myth busted!

  22. rejected a second person, a third-year student at Georgetown Law School named Sandra Fluke.

    Issa said the student did not have the appropriate credentials to testify at a hearing focused on threats to religious freedom

    So the Democrats first choice as a witness is a sophomoric Junior?

  23. They’re going with their strenghts, geoff.

  24. Obama last Friday modified that policy so that insurance companies, and not the organization affiliated with a church, pay for birth control costs,

    Only an economic imbecile could state this as true. Then again it is from those true believers in the economic versions of phlogiston and phrenology so…

  25. “So the Democrats first choice as a witness is a sophomoric Junior?”

    I caught a little bit of Issa in an interview with Van Susteren, where he said the young woman had a story to tell about a friend of her’s who had some sort of ovarian cancer that may have been [?] prevented[?] (who knows!) by some use of a particular form of birth control. But, said he, that was not the focus of the hearing, hence the rejection of her testimony in light of the subject and lack of expertise thereon.

  26. I still can’t wrap my head around the idea that if a third party, (one whose money comes from all of us, government, or all their customers, insurance companies so it is coming from the person complaining) doesn’t pay for my-your-her contraception pills-devices then I-you-she can’t ever obtain them, ever.

    How do these people manage to claw there way through even one day of life without expiring because no one has provided an iron lung so they can breathe since they can’ do it all on their own, helpless twits.

  27. “t” add as needed.

  28. Standard BC pills are available at Walmart for 9.95 for a months supply.

  29. Well there’s your problem. Walmart birth control pills? Pills that those redneck hicks buy? I DON”T THINK SO!

  30. OT: but is “cost” related.

    A few days ago it was noted that the hoopla over the mortgage settlement with the banks which the administration was taking star-turns for negotiating was anything but final. That the premature announcement itself might be a political hack job to advance one side of the deal over another.

    As is always the case in complex deals, the devil is in the details and especially the non-public ones.

    the FT reports tonight that Obama’s foreclosure settlement with the banks over their improper seizure of tax-paying US citizens’ homes will in fact be subsidized by those very same US taxpayers. It is a hidden clause (that has not been made public yet) that allows the banks to count future loan modifications under the $30bn (taxpayer funded) HAMP initiative towards their $35bn agreement to restructure obligations under the new settlement.

  31. One other thought. I’d bet a sizable chunk of these funds find their “well laundered” way, as always, into the campaign coffers of Democrats.

  32. It appears that the proteinwisdom twitter account has been hacked.


    payday loan online
    6:49 AM – 17 Feb 12 via HL Twittter · Embed this Tweet

  33. There was a tweet on Jeff’s account yesterday that said only “hi.” Also, a spammer has registered to comment…

  34. From geoffb’s linky…

    Why is it deeply troubling that the attorneys general have gone along with the Administration’s messaging and have all fallen in line with the “biggest Federal-state settlement ever” when no such settlement in fact exists? This isn’t just acceding to the Administration’s pet wish to build on its State of the Union PR. They’ve completely abandoned their negotiating leverage at a critical stage.

    Let’s look at this equation. The Administration and the banks both want a pro-bank deal (the only minor point of difference is how much in populist gestures the banks have to submit to in order to get the much more valuable bennies they want). The only parties that cared to any degree about ordinary citizens were the dissident AGs. But they now have now given up any bargaining leverage over how this deal turns out. …

    Yet in an interview with Dylan Ratigan early last week, he [Beau Biden (D), Delaware AG and son of Joe Biden] sounded as if the fight had been beaten out of him, that he was resigned to signing on to the agreement if he could preserve the MERS suit he had filed and add bank names to it later if the facts warranted. What sort of veiled or not so veiled threats did the Democratic party operatives make to get him to fall into line?

    No, there was no ‘beating of Beau’ by Democratic operatives. He willingly fell into line because his Party and the pushing of it’s far-Left ideology overwhelmed whatever principles he ever possessed; and made inconsequential whatever ‘Oath of Office’ he swore to when he took the plum, the office of Delaware’s State AG.

    Fucking dynassty creep, a chip off the old blockhead hisself, is Beau Biden.

  35. There was a tweet on Jeff’s account yesterday that said only “hi.” Also, a spammer has registered to comment…

    If that’s the case, then it’s likely Jeff’s personal PC has been taken over by a virus. I’ve seen this happen before, to individual’s PCs, after which all available accounts are then utilized for insect-like spam breeding and viral promulgation.

  36. I scanned my Mac. No viruses. We found some code that had been placed in WP.

    I changed my Twitter password just now. We’ll see what happens. I have no idea how to protect these things.

  37. Also, a spammer has registered to comment…

    Who? Where?

  38. It is a back-door way for the Feds to bail out big blue states. $18B of the $25B is going to California. Thanks Uncle Sugar, we’ll use it well. Now let’s dust off those plans for the Jerry Brown High Speed Rail project (not the Edmund Brown Aqueduct, my daddy built that!)and start spending that cash – we have an election to win.

  39. Thanks for the reach-around.
    Kamala Harris
    Antonio Villaraigosa
    Gavin Newsom
    Phil Angelides

    -The On-deck Team. Si Se Puede!

  40. Who? Where?


  41. And never forget that PPACA is going to save money, or so its proponents claimed repeatedly before it had passed, after it had passed, and, no doubt, will continue to do so after it is repealed.

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