On Monday, Sens. Jon Kyl (R-AZ), Mitch McConnell (R-KY), and Pat Roberts (R-KS) introduced the “Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009,” a new bill prohibiting Medicare or Medicaid from using “comparative effectiveness research to deny coverage.”
For Kyl, fear mongering about the consequences of government-takeover of health care or medical research is a part time job. He actively rallied against medical research during the stimulus debate, Kathleen Sebelius’ confirmation, and today, he took to the Senate floor to attack Democrats of seeking to “ration care”:
Pharmaceutical representatives currently instructs doctors on the effectiveness of medications, and the industry opposes research that would lead the government to eschew coverage for ineffective or unnecessary treatments. Fewer prescriptions translate into lower profits and the industry lobbied hard to pare down the cost effectiveness language in the House and Senate versions of the stimulus bill. In fact, the pharmaceutical and biotechnology industries have donated $1,971,968 to Kyl’s career election efforts and ran ads on Kyl’s behalf in 2006. Moreover, according to recently released 2008 personal finance disclosures, Kyl invests heavily in pharmaceutical companies.
His latest effort prohibits the government from using “data obtained from the conduct of comparative effectiveness research…to deny coverage of an item or service under a Federal health care system.” The language compliments the GOP’s larger argument that Obama’s health care reform would usher in the era of European-style socialized-medicine and rationed care, but it ignores the government’s existing ability to make coverage decisions.
As Thomas Scully, the Administrator of the Centers for Medicare and Medicaid Services (CMS) from 2001-2003 pointed out in an interview with ThinkProgress, “you know, Medicare makes decisions on coverage all the time. I made decisions on coverage all the time….You got to do it the right way. But I think – I’ve always been a big fan of comparative effectiveness research if done correctly.”
In reaching coverage decisions the Center for Medicare and Medicaid Services relies on an evidence-based process, conducts internal research and consults outside assessments. Upon CMS’s request, fifteen experts on the the Medicare Evidence Development and Coverage Advisory Committee review, evaluate, and collect medical literature and technological assessments and examine the data based on effectiveness and appropriateness. Only then, does the panel of experts issue a coverage decision.
It’s unclear why Kyl and his conservative colleagues would deny Americans the fruits of scientific research. The Food and Drug Administration oversees the safety of food, drugs, and cosmetics and bans the use of harmful products. If the government can ban harmful lipstick, why can’t it deny coverage for a dangerous drug or medical devise and protect access for patients who need experimental treatments? As Peter Orszag pointed out during recent Congressional testimony:
There also are a lot of less extreme ways of guiding medical practice. For example, simply paying more for the things that work than the things that don’t….And so it doesn’t need to be a simple on-off switch.
After all, “there is no reason we cannot set up reasonable procedures, overseen by independent health professionals, to protect patients who can demonstrate a special need for a treatment that is not normally cost-effective.”