This morning, Fox & Friends covered President Bill Clinton’s hospitalization by asking if the President would have been treated for his heart problems “if the health care reform had gone through.” “Would he have gotten those stents?” host Brian Kilmeade asked in-house health reform expert Peter J. Johnson Jr.
Johnson admitted that “under a lot of protocols he would have gotten those stents,” but suggested that if the government adopted best practice methods using comparative effectiveness research, “perhaps hundreds of thousands of people like the president” would receive a cheaper, less effective, treatment:
JOHNSON: If the government decides to adopt the Peter Orszag, budget director, architect of health care, method and put in regulations that say there is a gold standard, there is a best practice based on the literature, perhaps hundreds of thousands of people like the president, I’m not going to make a determination…if the new standard is save money, best practices, does President Clinton or you or I who needs it get the stent under the new regimen of health care effectiveness?
Conservatives have long used comparative effectiveness research (CER) to further their claim that health care reform would ration treatments based on cost, impose a one-size-fits-all standard for medicine, and keep doctors from prescribing more expensive and effective procedures. But this line of thinking misunderstands the purpose of CER and ignores legislative language that specifically prohibits the government from applying research findings to coverage decisions. CER is a recommendation, not a mandate. (See pg. 1652 of the Senate bill or pg. 769 of the House bill).
Rather than making arbitrary decisions based on cost, CER — which compares clinical outcomes of alternative therapies used to manage the same condition — 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. Properly conducted CER will actually promote faster adoption of personalized care, not one-size-fits all medicine.
As Alan Garber of Stanford and Sean Tunis of the Center for Medical Technology Policy point out, “far from impeding personalized medicine, CER offers a way to hasten the discovery of the best approaches to personalization, providing more and better information with which to craft a management strategy for each individual patient.”
Indeed, CER could have actually improved treatment for heart disease by exposing harmful procedures and informing health care providers about best practices. The course of treatment, however, will always be left to the patient and his or her doctor.
Cross-posted on The Wonk Room.