Conservatives continue to be right to point out that achieving the sort of health care cost savings progressives are talking about is easier said than done. That said, I continue to be baffled as to how it is that they keep thinking the main point here is to castigate the progressives trying to make things better rather than castigating the people who are actually making the cost savings difficult. For example, Senators Jon Kyl (R-AZ), Mitch McConnell (R-KY), and Pat Roberts (R-KS) have introduced a new bill that would attempt to prevent Medicare and Medicaid from using comparative effectiveness research in order to ascertain which services should be paid for.
The basic political game here is clear enough. On the one hand, conservatives want to say that health reform is too expensive. On the other hand, they want to denounce any effort to control costs as evil rationing. It’s a nice partisan game. But the policy substance is insane. As Igor Volsky points out, CER doesn’t change the fact that decisions need to be made. Instead all this is going to do is waste money and deny patients the benefit of accurate information about which treatments work:
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.
Again, if you want to take this as an example of how difficult it will be to reform Medicare and make it work, you’re welcome to do so. But please place your blame on the right people—on Kyl, on McConnell, on Roberts, and on others who want to block reform as a way of maintaining the viability of their partisan talking points. What we need in this country is a rational debate, in which conservatives at least stick to the story of being concerned about spending too much money, and then we can have a discussion about how to prevent that from happening.