I think before everyone gets excited about the effectiveness research that was funded in the Recovery and Reinvestment Act–basically, using the scientific method to find out how well different medical treatments work–we need to realize that the medical industry might have scored a coup here (italics mine):
The $1.1 billion earmarked for comparative effectiveness research remained in the bill that President Obama will sign Monday. The House conferees also insisted on keeping the phrase “comparative effectiveness” throughout the authorizing language, removing the Senate’s insertion of the word “clinical.” However, the report language did note its removal was “without prejudice.”
Now the bad news. From the conference report:
The conferees do not intend for the comparative effectiveness research funding included in the conference agreement to be used to mandate coverage, reimbursement, or other policies for any public or private payer. The funding in the conference agreement shall be used to conduct or support research to evaluate and compare the clinical outcomes, effectiveness, risk, and benefits of two or more medical treatments and services that address a particular medical condition.
The crucial question is whether the Agency for Healthcare Quality and Research (AHRQ) and the Center for Medicare and Medicaid Services (CMS), which get two-thirds of the money with the National Institutes of Health getting the remainder, will be able to take costs into account in determining “effectiveness.”
So we can look at clinical outcomes, but not costs? If we can’t even consider costs, I don’t see how we reduce healthcare expenditures. Yes, for some medical conditions, cost shouldn’t really be an issue, but, for others, such as choosing a hypertension drug, costs have to be considered. I guess this is a good start, but, if we want to stop spending around 16% of annual GDP on healthcare, we need to look at costs (of course, letting Medicare and Medicaid bargain with drug companies would help too…)