Tuesday, June 16, 2009

Comparative Effectiveness Research: Reform's New Hot Potato?

Trudy Lieberman of the Columbia Journalism Review has been doing an excellent job critiquing the media's coverage of the health reform debate, but as best as I can tell, she slipped up a little in her assessment of the role of the AMA:

http://www.cjr.org/campaign_desk/who_will_be_at_the_table_8.php?page=all

Overall she noted the pattern, that the AMA seems to be in bed with Big Pharma and the Republicans in opposing key aspects of the Democratic health reform proposals. The AMA indeed seems less interested in defending either health or medicine, and rather more committed to extolling the presumed virtues of the "free market." However, if you read the detailed AMA statement (to which she provides convenient links in her article) in response to the Senate Finance Committee, you'd see that in one key area, the AMA parts company with the drug lobby. Even the right-leaning ideologues who make up the leadership ranks of the AMA could not stomach the industry's position opposing comparative effectiveness (CE) research. Being, in the final analysis, physicians, they could not oppose a system that would perform scientific studies and inform them of what works and what doesn't.

Meanwhile, the Kaiser Daily Health Policy Report tells us today that the Republicans are pushing back harder against the Democratic bills, and that a ban on CE research is a key feature of the response bill that they are now offering:

http://www.kaiserhealthnews.org/Daily-Reports/2009/June/16/Comparative-Effectiveness.aspx

This suggests both that the pharmaceutical industry has basically bought off the GOP lock, stock, and barrel and harnessed the elephant to its opposition of CE. The fearmongers are now working overtime to convince us that CE is a sneaky way for the government to take over medical care and "come between you and your doctor." It seems quite intriguing that CE research has zoomed to the top of the charts, right alongside a public insurance option, as the hot potato of partisan bickering over health reform--another sign of how successful Big Pharma's lobbying machine is in imposing the industry's preferred agenda on the entire political process.

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