I suspect nearly everyone reading this column will agree that ovarian cancer is a terrible thing, and that preventing ovarian cancer, or predicting it and catching it early to enhance a woman’s chance of surviving it, is a good thing.

I open with those stipulations, burying the lede just a little bit, to preempt the obvious arguments against my position on this report from The Hill:

“A group of lawmakers spanning both parties and chambers is introducing legislation that would require insurance plans to cover genetic testing for patients with hereditary risk factors and expand education and outreach about gynecologic cancer risk. Sens. Elissa Slotkin (D-Mich.) and Katie Britt (R-Ala.) are leading the bill, the Ovarian Cancer IMPACT Act …”

Genetic testing for ovarian cancer risk sounds like a great idea.

And genetic testing for ovarian cancer risk (and other cancer risks) costs money — typically $250 to $500, sometimes less if fewer gene markers are screened for, sometimes much more if the tests are more comprehensive.

Before considering who should bear those costs and why, I should probably take a moment to  discuss the exact role the US Constitution assigns to Congress when it comes to the provision and delivery of healthcare:

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It’s simply not Congress’s business to decide what kind of testing or treatment your insurer or other healthcare provider may, or even must, offer.

Not that Congress pays attention to the Constitution when paying attention to the Constitution seems inconvenient. They just wave their hands, quack about “interstate commerce,” and mandate whatever they want to mandate about your healthcare options — even if you, your insurer, your healthcare provider, and the testing company are all located in the same state.

So, what happens when every insurance company gets told that, by law, it must pay for this or that kind of genetic screening?

In four words, everyone’s healthcare costs go up. Not just the healthcare costs of  women who are, or may be, at risk for ovarian cancer. Everyone’s.

Why? Because patients at such risk can’t be magically identified in advance and charged for those testing costs.

The costs can’t even be limited to the half of the population that MIGHT have to worry about ovarian cancer, because many healthcare policies are “family” policies provided through employers, and the single male who gets insured today may add a female partner or daughter to the policy tomorrow.

So, all of us get to pay for testing we may or may not ever want or need.

In a free and open healthcare market, many insurers might cover these tests as part of their normal policies, or offer them as cheap add-on options to those most likely to want them. After all, testing for ovarian cancer is much cheaper than treating ovarian cancer.

However, we live in the opposite of a free and open healthcare market.

Decisions about what testing, prevention, and treatment options get covered are made by politicians and bureaucrats, usually with the “assistance” of industry lobbyists who know which testing, prevention, and treatment options best serve their employers’ bottom lines.

The Ovarian Cancer IMPACT Act is almost certainly less about women’s health than about who enjoys a payday at others’ expense.

Like speech, press, and religion, we’d be better off with complete  separation of medicine and state.

Thomas L. Knapp (X: @thomaslknapp | Bluesky: @knappster.bsky.social | Mastodon: @knappster) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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