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Just When You Thought It Was Safe: 3 Potential Obstacles to Health-Care Reform

Harry Reid may have gotten the Senate to move his health-care bill forward, but a handful of conservative Democrats could still keep the bill from getting a final vote.

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Pro-choice House members have also laid down a marker, with as many as 40 saying that if the bill produced by a conference committee -- the last step in the legislative process before a final bill, where House and Senate bills will be combined -- contains the Stupak language, they won't vote for it. Rep. Diana DeGette, D-Colo., who co-chairs the House Pro-Choice Caucus with Rep. Louis Slaughter, D-N.Y., told AlterNet that she was engaged in discussions with pro-choice Senators Barbara Boxer, D-Calif., and Barbara Mikulski, D-Md., and was hopeful that the Senate would avoid the fate of the House bill with regard to abortion coverage.

The Rationing Ruse

If that wasn’t enough for Reid to deal with, this week the U.S. Preventive Services Task Force gave Republicans a big present with its controversial recommendations that women under the age of 50 forgo annual mammograms. The task force based its recommendations on the number of lives saved from the screenings, as opposed to the numbers of “false positives” and the amount of overly aggressive treatment often given women with slow-growing cancers. An uproar ensued, with advocates for cancer patients, such as Nancy Brinker of the Susan B. Komen Foundation, crying foul.

Although the task force was convened by the Department of Health and Human Services, the outcry prompted HHS Secretary Kathleen Sebelius to distance her agency from the guidelines, which were issued last Monday. On Thursday, Sebelius called a press conference to announce that women over 40 should continue with their annual mammograms. Amid the controversy, the Republicans saw an opportunity. With the myth of government-mandated "death panels" now fully discredited, they needed a new bogeyman for their scare-mongering on health-care rationing, and the task force unwittingly obliged.

Arguing against bringing Reid's bill forward, Sen. Tom Coburn, R-Okla., a medical doctor and member of The Family, suggested on the Senate floor that the task force’s suggested changes in mammography guidelines exemplified the kind of “rationing” one could expect to see if Reid’s health-care bill became law.

"Do these recommendations make sense from a cost standpoint?" he asked. "Absolutely, from a cost standpoint, they're right. From a patient standpoint, they're atrocious. And that's the problem with a bureaucracy stepping between a physician and their patient."

Coburn's gambit was set up earlier in the week by Rep. Marsha Blackburn, R-Tenn., who called a press conference to say that under the House bill, the recommendations by the task force would carry the force of law -- which is not true. What the task force will be empowered to do is to mandate certain preventive measures, not take them away. (Blackburn also, in a press release, called the task force "an agency of the Department of Heath and Human Services," which it is not. It is an independent commission convened by HHS.) But at a press conference, flanked by Jean Schmidt, R-Ohio, who once accused combat veteran Rep. John Murtha, D-Penn., of being a traitor, and Michele Bachmann, who, two days before the House health-care vote, used her congressional office to organize a right-wing rally against the president, Blackburn nonetheless said, "This is how rationing begins. This is the little toe in the edge of the water. This is when you start getting a bureaucrat between you and your physician. This is what we have warned about."

On ABC's This Week, Blackburn squared off with Democrat Debbie Wasserman-Schultz of Florida, a breast-cancer survivor who also opposes the new guidelines but supports health-care refrom, while Ben Nelson and Tom Coburn looked on. Blackburn painted a grave specter of "a government bureaucrat in the exam room" getting between the patient and her doctor. "There's an insurance company bureaucrat between the patient and her doctor right now," Wasserman Schultz replied.