Via Ezra Klein, Paul Krugman offers this excerpt from Mike Huckabee’s new book lampooning the Recovery Act’s investment in comparative effectiveness research — which compares clinical outcomes of alternative therapies used to manage the same condition:
Huckabee rhetoric is pretty standard Republican fare. Conservatives have long used comparative effectiveness research 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 reasoning is well contained to partisan political circles. Health care experts and scientists believe investing in this kind of research will 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, scientists think that CER will actually promote faster adoption of personalized care and provide “more and better information with which to craft a management strategy for each individual patient.”
The very obvious question when it comes to CER isn’t “who will get rationed.” It’s: if the government doesn’t base its coverage decisions on science or comparing the effectiveness of one drug or treatment against another, then what metric does Huckabee propose? Absent a credible source of sound scientific information, Medicare and Medicaid are wasting taxpayer dollars on treatments that don’t work or paying for medicines that achieve the same result as a cheaper alternative. Consequently, health care costs are increasing and 45 million Americans are uninsured. But Huckabee, Klein notes, supports this kind of “dumb rationing” rather than the “smart rationing” that is grounded in eliminating ineffective treatments through scientific research.