Another round of state laws mandating screening tests “that may have little effect on outcomes”

USA Today reports on 14 states considering some move toward mandating a newborn test looking for signs of congenital heart disease. Excerpt:

“The tests aren’t always accurate, however, and some doctors say they will prompt follow-up tests that could prove expensive — perhaps as much as $1,500.

“No question about it raising health care costs, it definitely will,” says Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H.

“Why is this being mandated by a legislature?” wonders physician Stuart Kaufman of Morristown, N.J. “There are some benefits, but they are passing a law that is going to increase the cost of health care at a time when health care costs are rising and we are trying to contain the cost. They are mandating a test that may have very little effect on the outcomes.”

Politicians love screening tests. Whether evidence supports the tests or not.

The National Conference of State Legislatures reports that at least 28 states have enacted laws requiring insurers to include coverage for PSA testing.

Coverage mandated by law – despite the fact that the US Preventive Services Task Force states that there isn’t enough evidence to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years, and it recommends against such screening in men over 75. And the American Cancer Society states “Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.”

And of course, the Affordable Care Act (federal health care reform legislation) ignored the 2009 statement of the US Preventive Services Task Force on mammography. Instead, the feds mandate mammography coverage based on the 2002 USPSTF statement, which was found to be more politically popular. Here’s the footnote on a federal website:

In the apparent attempt to look like do-gooders, politicians may inadvertently cause harm by legislating screening mandates that don’t reflect all of the available evidence.