Breast Screening Rules the Result of Bootleggers and Baptists

The new Senate bill will now mandate expanded coverage of breast screening:

The final health-care bill is likely to require coverage for more mammograms than the new guidelines recommend after women’s groups, doctors and imaging-equipment makers stepped up pressure on lawmakers — one of many threads of the bill negotiated behind the scenes.

Let’s first lay aside the notion that breast screening shouldn’t be part of insurance; it’s regular, not financially devastating, and predictable. There’s nothing to insure against. And let’s also set aside for now the fact that this mandate will increase the price of insurance. What this article really shows is that the health care bill — and all of regulation — is really the result of bootleggers and baptists.

Bootleggers and Baptists is the story of how advocates for regulatory reform. Baptists, the well-meaning advocates, want to outlaw alcohol because they think it’s a social ill. Bootleggers like prohibition because it drives their competitors out of the market. In the health bill, the “baptists” (women’s groups and doctors) and the “bootleggers” (imaging-equipment makers) both love the new mandate, but for very different reasons.

Remember that for every well-meaning attempt at regulation, there is probably a special interest benefiting from it. Repeat this story hundreds of times over and you’ll understand why Howard Dean wanted to scrap the health care bill.

Any measure that expands private insurers’ monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform.

Wise words, Mr. Dean.

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