Horrors! Those big-government Democrats are at it already, actually trying to get taxpayers to fund medical effectiveness research!
How dare the government actually fund research. The nerve! The gall! The (sputter sputter) utter brazenosity! (I know it’s not a word but it fits)
Why, doctors would actually know what works and what doesn’t! Care would improve, costs would drop, people would be healthier, there would be fewer medical errors; oh, the horror of it all!
And worst of all, taxpayers would get better results for their tax dollars!
Everyone knows there is just nothing more to learn about medicine, disease, physiology. We have learned all there is to know, and any money spent on effectiveness research would be wasted.
That, and the government might actually use that information to decide what types of care to pay for, and what types will not be reimbursed. Wow, what a concept. Why would the government ever contemplate basing reimbursement on effectiveness?
We would never want the government to be careful how they spend our tax dollars. Why, we never want to use taxpayer dollars to study the effectiveness of, say, military equipment. Or air traffic control. Or emergency preparedness. Or flood control. No, we should just pay vendors for any services they provide, regardless of whether or not those services actually work.
OK, forgive me for the over-the-top sarcastic rant. I’m completely disgusted with the hypocrisy of the libertarian right; those who have screamed for years about the ineffectiveness of government, ranting nonstop about how government can’t do anything right, yet are now screaming even louder as government attempts to make sure they are responsible stewards of the public’s funds.
Here’s an example from the health care experts at the National Review. “The [stimulus] bill provides $1.1 billion for a new program of comparative effectiveness research. The idea is to study medical practice patterns, new products, and new technology to determine what is “cost effective.” In the UK, a similar program run by the National Institute for Clinical Evidence (NICE) is used to deny payment by the government for certain drugs and procedures that are said to be “cost ineffective.”
Democratic lawmakers will deny that rationing is their intent, but that is not credible. Why create a government program to study what’s cost effective if not to use the information to inform payment and coverage decisions?”
Notice the use of the scary word ‘rationing’ to define appropriate coverage and payment. Using the author’s (James Capretta) reasoning, Medicare should pay for voodoo, cancer treatment with peach pits, snake oil, rhino horn, and universal cancer vaccines.
Why, not paying for these ‘treatments’ would be ‘rationing’…at least according to Capretta.
Capretta has zero experience in the real world of health insurance. Insurance companies make decisions every day to not pay for treatments that have been proven ineffective. If Mr Capretta had ever worked in the insurance or health care industries, he would know that. But he hasn’t.
That’s not ‘rationing’, it’s good business. Would you not want your government to only pay for services that work?
What does this mean for you?
Everyone knows government is the problem; how dare they try to be part of the solution?
Feb
2
I was hoping your link to “universal cancer vaccines” would have gone to the link for Wil Smith’s “I am Legend”.
Otherwise, I agree 100%. It would be nice to see new medications (and dosage forms) like Amrix (extended release cyclobenzaprine) tablets at several hundred times the equivalent cost) on the market…
It seems like a bit of a strawman that the “libertarian right” (I’m guessing that’s supposed to be small-government sex-haters as opposed to pot-smoking big-government types as a stereotype) would be against government doing a better job. If given the option of 1) real free market solutions 2) better government solutions and 3) worse government solutions, I’m not sure very many would take 3. That doesn’t generally preclude anyone from arguing in favor of 1 or pointing out the flaws in 2, however.
In this case, the reasonable libertarianish argument to make would be that the $1.2 billion is likely to be mismanaged through political maneuvering/pressure and general bureaucratic inefficiencies. It also might be worth pointing out that $1.2 billion in great data is still worthless if politicians on both sides are unwilling to discuss what you point out as effectively rationing. $1.2 billion in data destined to be ignored isn’t very useful. Still, the $1.2b might be better than spending $0 to explore the cost/benefit of certain treatments, but it might also leave room for a 3rd option that is generally more effective.
According to Mr. Capretta’s official bio:
“From January 2001 to May 2004, Mr. Capretta served as the Bush Administration’s top budget official for health care, Social Security and pensions, education, and labor policy. He was the lead official in the Office of Management and Budget for all aspects of Medicare and Medicaid reform policy development and implementation as well as for the development of the President’s other important domestic policy initiatives in education and labor.”
Let’s see – responsible for Social Security, Pensions, Medicare, Medicaid, Health Policy, and more. That all worked out well. Covered himself with glory, didn’t he?
Joe–
exhibit 1 for the “independent government body for effectiveness research”: the bone marrow transplant for breast cancer disaster of the 1990s
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I am all in favor of government getting handle and being better stewards of your money and mine– then let them start, not with new programs costing billions more, but rather begin by answering the question of the Ponzi scheme known as Medicare.
Start by simply answering that question, which is worth about 34 TRILLION dollars.
Answer– blank out, because neither party would ever openly say they would ration care to Medicare beneficiaries.
As someone who has never taken care of a single patient, you should be a little careful throwing stones at Mr. Capretta.
Eric – thanks for the note.
1. Effectiveness research is precisely what we must do to start getting a handle on medicare expense. Right now medicare pays for services that are not useful or helpful. This is a disservice to all; for Capretta to claim it is somehow rationing to seek to improve medical care is ludicrous at best. We have to control Medicare’s underlying cost drivers if we are to have any chance of addressing costs.
2. Yes government run studies have had some unfortunate results. They have also had very positive results, many of which have been distorted or discounted for political or economic reasons, or outright ignored by the medical community. Just a couple examples – the PORT for BPH back in the nineties, the Feds’ attempt to control the proliferation of MRI machines.
3. of course neither party would say they would ration care. This ‘new program’ is designed to ensure we pay for care that helps, and prevent ‘care’ that has no benefit or harms patients. Why would anyone protest that expenditure?
4. I don’t understand your comment about my not taking care of a patient. I’d suggest that if your statement is valid, it has nothing to do with my post. Why do you feel it necessary or helpful to tell me what to say or do?
Paduda
Joe- not attacking you directly… quoting you: ”
Capretta has zero experience in the real world of health insurance.”
If personal experience is a direct requirement for opining or taking positions in the health care debate, shouldn’t everyone be held to the same standard?
I am all in favor of work done for effectiveness reasons… I just do not think that billions of taxpayers funds will get us closer to where we need to go— since, for example, competitive bidding for DME was SHOWN to save taxpayers money, but was eliminated by Congress out of politiical expediency.
Eric – Actually that was a direct attack.
I did not say personal experience was a requirement for taking positions, I pointed out that he does not have any experience in and obviously does not understand how the insurance industry works. You somehow construed that to mean I view direct experience as a requirement to opine. Nowhere did I say or imply that.
What objections do you have to Federally sponsored research that dramatically reduced the number of carotid endarterectomies? Recommended hospitals prescribe aspirin for patients presenting at the ER with chest pain? These initiatives, and others which have seen strong resistance from the medical profession, did not come from private industry. And managed care plans have shown zero ability to conduct and promote similar efforts. The medical community actively resists many attempts to hold them to standards of quality.
Do not conflate the performance of the Federal government over the last eight years with all government. Remember, perhaps the best health care system in the country is run by the Federal government. It’s the VA.
I think some of the objections might be that it has absolutely nothing to do with stimulating the economy and it’s included in the stimulus bill. File a separate bill, get the funding, have a debate on the merits.