Comparative effectiveness and rationing

19 Jun
2009

 

Hats off to Pauline Chen whose tweet alerted me to this article.  Health Care Rationing Rhetoric Overlooks Reality

Here are the key thoughts:

“Just because there isn’t some government agency specifically telling you which treatments you can have based on cost-effectiveness,” as Dr. Mark McClellan, head of Medicare in the Bush administration, says, “that doesn’t mean you aren’t getting some treatments.”

Milton Friedman’s beloved line is a good way to frame the issue: There is no such thing as a free lunch. The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it’s hard to argue that we are now rationing very rationally.

On Wednesday, a bipartisan panel led by four former Senate majority leaders — Howard Baker, Tom Daschle, Bob Dole and George Mitchell — will release a solid proposal for health care reform. Among other things, it would call on the federal government to do more research on which treatments actually work. An “independent health care council” would also be established, charged with helping the government avoid unnecessary health costs. The Obama administration supports a similar approach.

As DrRich tells us repeatedly, we currently use covert rationing.  Covert rationing is usually irrational from a patient perspective.  We should become transparent to proceed with honest rationing.  Perhaps we will start paying for value rather than glitz.

 

Related posts:

  1. The R word
  2. We need comparative effectiveness and cost effectiveness
  3. Comparative effectiveness research
  4. Comparative effectiveness research – more thoughts
  5. Comparative effectiveness

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