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 yesterdayâ€™s mark-up of the HELP Committeeâ€™s â€˜Affordable Health Choices Act,â€™ 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 isnâ€™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 â€¦ wasteful spending.
- Politicians who warn that the burden of entitlements is killing the federal budget are stepping in to block â€¦ the single most painless route to reducing the growth of entitlements.
- Theyâ€™re doing it in the name of avoiding â€œrationing of health careâ€ â€¦ but theyâ€™re specifically addressing taxpayer-funded care. If you want to go out and buy a medically useless treatment, Medicare wonâ€™t stop you.
- These same politicians are, of course, opposed to efforts to expand coverage. In other words, itâ€™s evil for government to â€œration careâ€ 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