At least, that’s the
theory.

The theory met messy reality last week when the U.S. Preventive
Services Task Force recommended that women in their 40s shouldn’t get
mammograms. But the secretary of health and human services — who, incidentally,
oversees this panel — thinks women probably should. And the American Cancer
Society believes that they definitely should; major private insurance companies,

for the record, will continue to fund the tests.

Confused
yet?

Recommendation from a largely unknown government panel hardly seems
like typical material for national headlines. But when it involves breast cancer
and the announcement is made in the heat of debate over health reform, people
are — understandably — concerned.

The U.S. Preventive Services Task
Force, as it turns out, is not part of a larger Obama White House rationing
conspiracy, as some would have it. Task force members were appointed by
President Bush, and they voted on this recommendation before Obama’s
inauguration.

As for cost considerations, the task force had none:
Members are mandated not to weigh dollars and cents when considering the risk
and benefits of recommendations.

That’s not to suggest that their
conclusion isn’t highly controversial. For starters, it seems counterintuitive:
Early screening for cancer makes sense.

No wonder, then, that a full 87
percent of Americans believed that routine scanning was “almost always a good
idea” in a 2004 poll published in the Journal of the American Medical
Association.

Today, American panels and doctors groups are moving away
from the “scan first, ask questions later” philosophy. We aren’t the only ones
having second thoughts.

In Japan, all newborns were screened for

neuroblastoma starting in 1984, but the program was scrapped a few years ago
when more babies died from unnecessary surgeries than the obscure
cancer.

For many, such reversals are deeply unsettling, a reminder that
medicine is far from an exact science.

“The history of medicine is a
record not only of brilliant success and stunning progress,” Theodore Dalrymple,
a British physician, wrote in 2002. “It is also a litany of mistaken ideas and
discarded treatments, some of which came to appear absurd or downright dangerous
after having once been hailed as unprecedented advances.”

As a physician
myself, I know a thing or two about going by the book and getting it wrong. When
I was in residency, the standard treatment for bipolar patients suffering
depression was Prozac or its sister drugs. It turned out that Prozac
intervention was not only highly problematic, but also bested by
placebo.

For those on the left, the answer to the chaos of medicine is to
establish government panels. With Obamacare, for instance, White House officials
propose a commission to cut hundreds of billions from Medicare by improving the
quality of care.

How? By setting up an Independent Medicare Advisory
Commission that would guide clinical decisions for doctors and patients
alike.

The controversy over breast cancer screening, however, shows the
political and practical limitations of this one-size-fits-all approach: Medical
organizations have difficulty in setting and agreeing upon clinical guidelines,
and patients are apt to resent mandates from bureaucrats.

Leaving health
verdicts in the hands of centralized authorities is a sure way to keep making
mistakes in a field where re-examination and reversal are an unavoidable
reality.

David Gratzer, a physician, is a senior fellow at the
Manhattan Institute and author of “Why Obama’s Government Takeover of Health
Care Will Be a Disaster” (Encounter Books,
2009).