Last week in “Restating the Obvious” I quoted Erick Erickson of RedState:
Jay Rockefeller, Ted Kennedy, Barack Obama, and a host of liberal writers admit that the government will determine whether or not to treat you based on whether the government thinks the cost/benefit analysis makes sense.
And I asked if anyone knew were Erickson got such an off-the-wall idea. Well, I stumbled across the “source” yesterday. Harold P of Democracy for America says the righties are scrambling what’s called “comparative effectiveness research (CER).”
What is CER? Dr. Howard Dean explains:
At issue is something called “Comparative Effectiveness Research” which basically means giving your doctor access to the latest research on what treatments and therapies work and which don’t. This also helps doctors know which treatments are more expensive than others, and helps both patients and doctors decide if there is a cheaper treatment that is just as effective. As a doctor and the husband of a doctor, I know how important it is to have solid scientific research to make critical decisions for my patients.
This research will help doctors choose the best treatment for their patients’ situation and help them make more informed choices rather than risk prescribing less effective or even potentially harmful treatments.
Essentially, in order to control costs and provide patients with better care as we reform health care, the Federal Government will fund and disseminate research that evaluates the effectiveness of different treatments and medicines. This research will give doctors and patients better choices, and most importantly better health care for their money.
This is a common sense idea that should have been put in place a long ago.
Naturally, the Right is against it. Igor Volsky wrote for Think Progress on June 19:
During yesterday’s mark-up of the HELP Committee’s ‘Affordable Health Choices Act,’ Sens. Tom Coburn (R-OK), Pat Roberts (R-KS), Mike Enzi (R-WY) and Orrin Hatch (R-UT) introduced multiple amendments preventing the government from using the results of comparative effectiveness research (CER).
Of course they did. What else would you expect?
Responding to the Republican charges, Sen. Barbara Mikulski (D-MD) pointed out that existing language already prevented the new comparative effectiveness council from using the research to make coverage decisions. …
…The government isn’t mandating that doctors adopt the results of CER and it is not rationing care. Each patient has his or her unique needs and the ultimate decision for how to proceed should be left to the doctor and the patient. Currently, approximately one-third of all treatments have never been proven to produce better outcomes; CER would provide doctors with unbiased information about the most effective treatments, help doctors and patients make better informed decisions, and improve the quality of care.
(It seems to me that one of the results of CER might be that doctors do less over-treating and over-prescribing, which the Right has complained about for years. The Right’s complaints are in the context of scare stories about out-of-control malpractice litigation, charging that fear of lawsuits causes doctors to over-treat and over-test, thus running up the cost of medicine. However, this is a charge I’ve been looking into lately, and the “defensive medicine” claim appears to be mostly myth, albeit a myth many doctors believe. Over the past couple of decades several states have passed stringent “tort reform” laws that have drastically reduced the number of lawsuits filed in those states. And guess what? Doctors continue to order as many tests and as many treatments as they did before. But that’s another post.)
So how did the fevered imaginations of righties turn CER into rationing? You can trace that back to a column written in February by Betsy McCaughey. As Harold P at Democracy for America explains, McCaughey’s article is grossly inaccurate. But it established the conflation of CER with rationing, and the Right won’t let go of it.
How bad is it? Let me count the ways.
- Politicians who rail against wasteful government spending are taking action to prevent the government from reining in … wasteful spending.
- Politicians who warn that the burden of entitlements is killing the federal budget are stepping in to block … the single most painless route to reducing the growth of entitlements.
- They’re doing it in the name of avoiding “rationing of health care†… but they’re specifically addressing taxpayer-funded care. If you want to go out and buy a medically useless treatment, Medicare won’t stop you.
- These same politicians are, of course, opposed to efforts to expand coverage. In other words, it’s evil for government to “ration care†by only paying for things that work; it is, however, perfectly OK, indeed virtuous, to ration care by refusing to pay for any care at all.
See also Ezra Klein
Step 1: Drug patent expires and drug goes generic. Drug company makes small tweak to drug (“Now with blue crystals!”) and repatents the name-brand drug. Starts marketing the “improved” version.
Step 2: Government CER study proves that generic is just as good as tweaked name brand.
Step 3: Dr’s go back to prescribing name brand and drug company loses money.
Repubs, never having met a Big Phara member they didn’t like, but unable to say the obvious out loud, needs to head this off at the pass. So “Obama admin plans to ration health care based on cost/benefit analysis.”
They’ve never let Krugman’s little inconsistencies get in their way before. Why start now?
I wrote my comment (currently awaiting moderation) before reading Klein. I disagree a bit with Klein in that I don’t believe they truly have an ideological objection. I think they’re hiding their profit objection behind the ideological objection, or are being paid to do so by Big Pharma. Call me cynic.
This is all political posturing.
If Dem’s pass a successful health care reform package that people like, the Republican’s will wander in the political wilderness for 40 years, much as they did after Social Security. They will work to obstruct any positive legistlation regarding health care.
And yet the Dem’s look to compromise, and find a bi-partisan solution! I can’t believe that the Dem’s are that short-sighted. But, I guess that’s what lobbyist’s contibutions to campaigns will do for your long-term outlook.
We desperately need publically funded elections! PERIOD!!!
Olbermann took McCaughey apart in February.
http://mediamatters.org/mmtv/200902120027
The whiny-ass titty-babies of the right will fumfer and say, Um, well, um, see, um – well, they’re saying they won’t use it *now* but – um – in the future, see, they’ll start using it, so we have to ban it now so they won’t be able to use it then. Um.
This whole folderol about the gubmint denying care based on a cost/benefit analysis is so infuriating to me, not just because it completely misinterprets the point of cost-effectiveness research, but it suggests that I am not now the victim of coverage based on cost/benefit analysis. But I am! And it’s a cost/benefit analysis that is based on making sure insurance CEOs have lots of money and big houses.
I would love it, and think it a big improvement, if a transparent government process told me that I would have a bigger copay for one drug than for another similar one, because one was more effective. As it is, my insurance company tells me what’s on its “formulary”, and I have no way of knowing why, and whether it’s because a drug is more effective or because its manufacturer cut a sweet deal, or whether its salespeople sleep with the insurance people. It’s utterly opaque, subject to seemingly random change, completely exploitative, and highly suspect.
And the GOP thinks we should keep it.
yes cundulag. and we also need to get the lobbyist out of our government
Premise: Leaders of both parties agree it’s their job to keep Americans safe.
Question : Why then is there is any debate on whether it’s government’s job to keep Americans alive?
How can it be a tragedy of cosmic proportions if I die because I was in the wrong building on 9/11, but an incidental loss when thousands die for lack of medical care that they simply can’t afford?
The only things wrong with your analysis are: 1) They already say this; and 2) they say it clearly and confidently, without any hemming and hawing, safe in the knowledge that the host of whatever show they’re on will never say “What the $^&% are you TALKING about?!!?”
I was just about to comment on this very phenomenon: Nothing dissuades the right from their fever dream. Lay out the facts that prove that they’re straight-up wrong, and they’ll say, “Yeah, but they’re Democrats – they may SAY they’re not going to (fill in the blank), but you just KNOW they will!”
Cf. Obama’s tax plan, which lowers taxes for virtually all of the country and raises taxes on the richest 2% back to 1999 levels: “Yeah, but that’s for now. Just you wait – you’ll see!”
Oh, one other thing I forgot – NOW conservatives are against cost-effectiveness studies? So I guess they’re admitting that their 30-year war against “welfare queens” is straight-up meanness and racism?
And another thing – It’s way past time to push back on this construction:
Got a link, or some video, of any of these people saying “I admit that the government will determine whether or not to treat you based on whether the government thinks the cost/benefit analysis makes sense”?
No? Then you’re analyzing and opining. Which is fine. But say it.
They all got the vapors when we said that McCain said 100 years in Iraq was fine by him, because “that’s not EXACTLY what he said! He said that if a couple of things which are never gonna happen happened, it’d be fine by him! You’re twisting his words! WAAAAAH!” All the while saying that Obama “wants to surrender in Iraq” and hoping we didn’t notice that they’re doing the exact same thing.
Can we just take it as a general given that if something makes sense the right is against it?
Turned around, this become a way to recognize which ideas make sense – if the right is for something, it doesn’t. If they are against it, it does.
Simple!