A Public Health Framework for Screening Mammography: Evidence-Based vs Politically Mandated Care

 JAMA

 The ACA improved the public’s health by guaranteeing that insurers provide uniform, cost-free access to preventive services based on modern evidence of effectiveness. The public’s health is best served when women’s personal decisions about screening are informed by evidence rather than political considerations. Congress’s paternalistic response to USPSTF mammography screening recommendations vividly illuminates the social costs of politically mandated care. Rather than benefiting women, political interference with science can discourage shared decision making, increase harms from screening, and foster public doubt about the value and integrity of science.