We're in the age of FORCED WELLNESS or else...and even for those who love "free" checkups the idea of being forced to get one or else lose your health insurance, be charged up to thousands of dollars more for your health insurance or face providers who refuse to treat based on an individual's choice to refuse forced testing should be frightening.
Our health should be our business absent a component of contagion and forcing checkups, screenings and participation in wellness programs on people who worry about the rampant misdiagnosis in our healthcare system, the emotional strain of referral after referral, the physical consequences of medical testing, the out-of-pocket costs of endless referrals to "look further," the potential breaches of privacy, the Obamacare coercion ranging from forced purchase of health insurance to provider bullying based on the dual provider money interests of obtaining fees for testing and practicing defensive medicine, as well as the money interests of insurance companies and government payers should not outweigh consumer interests.
In addition to often being bad medicine that's justified based on conflicting interests of insurers wanting to have all the information they can get on insureds and physicians wanting to protect themselves from liability by making sure they investigate "everything" with the added Obamacare additional payments to providers, Obamacare has failed to accompany such control over us with sufficient protections against privacy breaches, misuse of information and remedies for wrong information making our reduced ability to refuse optional screenings and tests even more perilous.
Maternal Depression Screening: Much like the proposed disgraceful gun control proposals put forth by the President [see "Obama's Vile Plan for Mental Illness: Gun Control through Suicide Control," http://conoutofconsumer.blogspot.com/2016/01/obamas-vile-plan-for-mental-illness-gun.html], the United States Preventive Services Task Force is now recommending maternal screening for depression during and after pregnancy (only New Jersey currently requires such screening).
And much like the proposed gun control rules (and the possible forfeiture of second amendment rights based on reporting by mental health providers), the consequences of these maternal screenings can be serious-- the risk of losing custody of one's children based on non-mental health experts' assessment of maternal mental health.
There are other reasons to worry. With so much at stake, reputation, custody of children, the presumption that primary care providers or pediatricians seeing a mother's children should have the authority to screen mothers for depression and take action based on a 10-question survey (Edinburgh Postnatal Depression Scale) should be raising alarm bells in every pregnant or new mother.
Also typical of Obamacare's plague of justifying intrusion under the guise of prevention where who, how, or how long, or how the information can be used is not defined in the suggestion are Obamacare incentives of easy money, payments to providers for this new screening which will encourage provider bullying and threats of refusal to treat if people don't comply and that's IF patient choice is preserved in these screenings and tests.
In a New York Times article from yesterday, 1/26/2016, "Panel Calls for Depression Screenings During and After Pregnancy," Pam Belluck explains that "While pediatricians and obstetricians were trained to screen, they were not compensated for screening, a study by Dr. Kozhimannil found," http://www.nytimes.com/2016/01/27/health/post-partum-depression-test-epds-screening-guidelines.html?_r=0.
In addition to paying providers to administer the screenings and formulating vague standards for what is going to be done or could be done based on such screenings, these policies ignore the realities of healthcare in our country including the over-testing by providers to protect themselves from liability (defensive medicine) that Obamacare further encourages by paying providers for testing and screening,
the fact that testing is often flawed or incorrect,
the fact that physical testing frequently has side effects,
and the fact that PREVENTIVE is always a MONEY SAVING tool rather than primarily a life-saving tool created by health insurers and other payers of benefits to better price their products to cover the POTENTIAL risks of what they might have to cover.
In case some starry-eyed novice believes that either the government or health insurers are focused primarily on health rather than money, let's dispel that right away.
If health is a priority and health insurance is seen as the best means of reducing barriers to healthcare and Obamacare truly provides for policies that make health insurance an affordable financial product to help pay for needed healthcare and services, then the Affordable Care Act would not have to force people to purchase health insurance or face a fine (the individual mandate).
If the forced purchase of health insurance is justified by saying that without health insurance people face barriers to care then people who don't have money wouldn't be "EXEMPT" from health insurance under Obamacare (which they are unless they're eligible for Medicaid).
If health is a priority then taking steps to make sure there are sufficient numbers of providers who provide needed medical care (rather than checkups) would be a priority, which it is not true under Obamacare which has worsened the problem of narrow networks (search Obamacare narrow networks).
If health is a priority then access to the best institutions for the treatment of ailments would be available to individuals which they are not as more and more hospitals selectively refuse certain insurance policies. [see for example Kimberly Leonard's US NEWS article of 11/14/2015, "Doctors, Hospitals Say 'No' to Obamacare Plans," http://www.usnews.com/news/articles/2015/11/04/doctors-hospitals-wont-accept-obamacare-marketplace-plans].
If health was a priority then capturing patients into an endless maze of testing and screening and referral wouldn't be more lucrative for providers than seeing more patients ["Ultimately, highly paid doctors were found to receive more payment for multiple tests on one patient than for treating multiple patients. [See: "Study: Doctors Paid More for Multiple Procedures Than for Multiple Patients," Andrew Soergel, 12/8/2014, http://www.usnews.com/news/newsgram/articles/2014/12/08/study-doctors-paid-more-for-multiple-procedures-than-for-multiple-patients].
If health is a priority then there would not be new CMS payments to physicians to talk to patients about the odds a particular treatment might work and whether it's worth the financial expense (CMS end-of-life talk).
If health is a priority then hospital errors would not be the third leading cause of death in the US [eg "Why Are Medical Mistakes Our Third Leading Cause of Death?"11/20/2014 06:46 pm ET | Updated Jan 20, 2015, http://www.huffingtonpost.com/allen-frances/why-are-medical-mistakes-_b_5888408.html] and obviously more procedures, more opportunity for errors.
If health is a priority misdiagnosis would not be rampant and recent attention drawn to the growing problem would not ignore over-diagnosis ["[Dr. Donald] Berwick, who also reviewed the report for the institute, cited one crucial omission--the committee decided not to address over-diagnosis, a diagnosis that is made that is not helpful to patients. 'They might not define that as an error,' he says, 'But I think the task of addressing over-diagnosis is critical,'" http://www.usnews.com/news/articles/2015/09/22/iom-study-shows-errors-in-diagnosis-harm-countless-patients-each-year.]
If health is the priority and the goal is to encourage people to get care, Obamacare wouldn't force patients to undergo tests and screenings or face physician rejection in lieu of the arguments pro and con of such preventive tests.
(See articles on too much medical care such as:
"One Patient, Too Many Doctors: The Terrible Expense of Overspecialization, Dr. Sandeep Jauhar, 8/19/2014, http://time.com/3138561/specialist-doctors-high-cost/, where Dr. Jauhar notes, "A large percentage of health care costs is a consequence of induced demand — that is, physicians persuading patients to consume services they would not have chosen had they been better educated."
"5 Questions You Must Ask Your Doctor Before Getting Any Tests," 1/3/2014, Leana Wen, http://www.womenshealthmag.com/health/too-much-medical-care
"Too Much Medicine is Bad for Our Health," Allen Frances, 9/13/2013, http://www.huffingtonpost.com/allen-frances/too-much-medicine-is-bad-_b_3920844.html, Putting Tests to the Test: Many Medical Procedures Prove Unnecessary—and Risky, Tara Haelle, 3/5/2013, http://www.scientificamerican.com/article/medical-procedures-prove-unnecessary/.)
Obamacare is about money and as if all the above examples are not enough, we now have FORCED WELLNESS.
FORCED WELLNESS: The old wellness programs created by health insurers to keep the group of people they insured healthier to maximize their savings rewarded individual participants willing with a few dollars off premiums. But under Obamacare's tyranny, such programs are now becoming compulsory.
And so, the voluntary wellness programs are becoming requirements with people risking penalties amounting to thousands of dollars or a complete denial of health insurance if they don't comply with health insurer wellness programs. "Employee Wellness Programs Not So Voluntary Anymore," Rebecca Greenfield, 1/15/2016, ( http://www.bloomberg.com/news/articles/2016-01-15/employee-wellness-programs-not-so-voluntary-anymore). A court has already upheld terminating an employee's health insurance for non-participation in wellness, "Big Employer Win in Wellness Program Case EEOC v. Flambeau," Paul M. Hamburger and Tzvia Feiertag, 1/20/2016, http://www.erisapracticecenter.com/2016/01/20/big-employer-win-in-wellness-program-case-eeoc-v-flambeau/.
While insurers and employers are winning court cases that get around the EEOC's requirements that wellness program participation must be voluntary by arguing that insurers need the information to better price their products for populations (preserving their profits by anticipating costs) and that as long as the information isn't used to deny people jobs, again reality must be making someone notice that just as criminal background checks aren't supposed to be used to deny employment for jobs that have little relation to a particular offense, that employers often concoct other reasons for denying jobs to those with any criminal record and that the same method will be used by employers looking to save money that will concoct a reason for getting rid of their more expensive to insure employees.
Forced wellness and forced prevention are not good medicine for consumers whose choices and decision-making about their own health and healthcare have never been more limited nor the stakes for consumers so high as they are under the stated and evolving policies of Obamacare.
