CBO Director On Medical Research: ‘Information Alone Is Not Enough, It’s Acting On The Information’

Today, during a Senate Finance Committee hearing on the costs of reforming the health care system, Sen. Bill Nelson (D-FL) asked Douglas Elmendorf, the director of the Congressional Budget Office, to debunk the myth that that comparative effectiveness research would lead to the rationing of health care:

NELSON: We got some extremist statements that came out from some sectors of the body politic about the stimulus bill, that there were in this comparative effectiveness research that it was going to cause a denial of medical treatments…Why don’t you debunk that theory?

Listen:

Elmendorf explained that comparative effectiveness research is a way to find out which treatments and procedures work, and which don’t. By itself, research “doesn’t change the care that is delivered; it provides the information,” Elmendorf stressed. The separate question is how will doctors and hospitals respond to this information and what incentives are “provided for them.” “The challenge is that information alone is not enough. It’s acting on the information”:

To generate more savings, we will need legislation to provide incentives on penalties for following or not following where that information leads and this particular legislation does not do that… it’s complicated…the studies are not going to say in general this whole type of medicine is completely worthless or this whole type of medicine is completely useful. It will be much more nuanced than that and that’s part of the challenge in creating incentives for providers to do these things that are useful and not.

In the long run, comparative effectiveness research could be used to make health care more cost-effective and government should be able to design policy (by tweaking Medicare reimbursement rules and getting doctors to adopt best practices) that promotes the best practices and lowers health care costs without refusing to pay for popular treatments. So as Elmendorf suggests, the argument isn’t about rationing or denying care; that’s a red herring. The question is: how do we encourage doctors to improve health quality and eliminate the use of wasteful and harmful treatments?