Tuesday, July 28, 2009

Texas Heart Screening Law - Medical Excess?

Fort Worth Star-Telegram columnist Steve Jacobs writes that a new law in Texas mandating coverage of widespread coronary screening for older adults is an example of "medical excess" whose implications reach beyond the Texas border.

"The new Texas law is a classic case of marketing and advocacy preceding science," Jacobs writes. "Ideally, medicine should be based on evidence, not belief."

The law was the idea of State Rep. Rene Oliveira, D-Brownsville, who says coronary screening saved his life by revealing severe blockages that resulted in bypass surgery. Beginning Sept. 1, Texas health-benefit plans must pay up to $200 for coronary artery calcium (CAC) scans and carotid ultrasonography for men ages 45-75 and women ages 55-75, as well as anyone regardless of age who has diabetes or is considered at least an intermediate risk for heart disease.

But the U.S. Preventive Services Task Force — the gold standard in unbiased healthcare recommendations — is against routine CAC screening, because there is no scientific basis that this sort of screening improves health outcomes. The American Heart Association, which cautiously recommends its use for selective patients, did not support Oliveira’s bill.


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