Tuesday, March 23, 2010

Now It's Time To Start Clearing the Land Mines..CER

As one who personally was very happy to see the health reform legislation signed today by President Obama, I wish I could take time out to celebrate this historic event; but my task here requires that I keep careful watch on who has made out like a bandit in this big sausage-making process. The press is starting to fill up with scorecards on winners and losers, and sadly, many of the special interests who are bringing you the mess that is U.S. health care today are big winners (one being the pharmaceutical industry).

This post follows up on previous posts such as:

We noted there that the Senate bill had a much worse comparative effectiveness research (CER) provision compared to the House bill. Sadly the Senate version has now prevailed in the final bill. That prompted a cheery press release from PIPC (Partnership to Improve Patient Care):

PIPC is extremely pleased with the new comparative effectiveness research apparatus. That's because as we noted before:
--PIPC is mainly funded by the drug industry and by some medical organizations like the American College of Cardiology (which should be ashamed) that want to be sure that CER never exposes their lucrative gravy trains and puts a stop to their profits by pointing out that the same medical benefits could be achieved at much lower cost. Therefore PIPC has been waging a stealth campaign, superficially applauding CER while trying hard behind the scenes to be sure that CER never gets to grow any teeth. So PIPC really likes the Senate version, that avoids giving control of CER to a group like the Agency for Healthcare Research and Quality, that actually could manage CER effectively and wisely, and creating a private body to oversee it--assuring that representatives of industry (who have no place on any such board that is serious about its business) are well represented. (All in the noble cause, of course, of keeping government out of your health care decisions.)

It will be essential for all who believe that we need genuine CER, that addresses cost issues alongside of benefit and safety issues, to move as quickly as possible to amend that section of the legislation. Put that near the top of your Post Reform To-Do List.

1 comment:

Michael Kirsch, M.D. said...

I agree with you entirely on the need for CER. Implementing it will create a volcanic reaction from various players in the game whose careers, incomes and companies are at stake. If CER challenges a medical treatment, then the research will be attacked as biased and flawed. If CER supports a treatment, then it will be hailed as groundbreaking. Keep in mind, that the public has been taught that more medical care means better health. Try talking a patient out of getting an MRI that he is convinced he needs, and probably doesn't have to pay for. www.MDWhistleblower.blogspot.com