RSC: Concerns on the Comparative Effectiveness Research Provision in Porkulus

This just in from the Republican Study Committee:

In addition to many other provisions of concern to conservatives, the Democrats’ so-called “stimulus” package establishes a Federal Coordinating Council for Comparative Effectiveness Research (CER). This new health board lays the groundwork for a permanent government rationing board prescribing care in place of doctors and patients.

Conservatives may believe that a board made up of 15 presidentially-appointed bureaucrats that is removed from the people with no input from patients and providers is not the correct way to gather and disperse CER information. This can and should be encouraged in the private sector to help doctors and patients if they so choose.

While the Senate version made some “improvements”, they are not enough. In the Senate bill the term “clinical” was inserted before “comparative effectiveness research” to try and limit what the board can consider and unlike the House, the accompanying language does not say anything about using the board to determine “cost effectiveness”.

While the conference committee has not yet come to an agreement on CER, unfortunately, many outside groups believe that Rep. Obey and his staff, who oppose inserting the “clinical” language and believe that the end game is to make cost effective decisions (ration care), will win out, as this isn’t necessarily considered a significant provision in the bill.

While the Democrats continue to argue that this board is simply a way to collect and disseminate information, their true intentions are clear through various statements including:

Draft report language accompanying the Appropriations health portion of the bill:

“By knowing what works best and presenting this information more broadly to patients and healthcare professionals, those items, procedures, and interventions that are most effective to prevent, control, and treat health conditions will be utilized, while those that are found to be less effective and in some cases, more expensive, will no longer be prescribed.”

Jeanne Lambrew (Deputy Director of the White House Office of Health Reform) at last week’s Health Policy Conference:

“There is a bipartisan – I should be careful about the bipartisan, working the bipartisanship in the Senate. The House isn’t quite as bipartisan as we would like but there has been support for investing about $1.1 billion in this economic recovery act for over two years for ARC and partly for NIH and partly for under agency activities to begin to try to say how do we get at the relative costs, excuse me, the relative effectiveness of the different services.”

Tom Daschle in his book Critical: What We Can Do About the Health Care Crisis:

“The Federal Health Board wouldn't be a regulatory agency, but its recommendations would have teeth because all federal health programs would have to abide by them…Congress could opt to go further with the Board's recommendations. It could, for example, link the tax exclusion for health insurance to insurance that complies with the Board's recommendation.”

However a big surprise and disappointment for patients everywhere is that members, including Reps. Pelosi, Hoyer, Waxman, and Dingell, who previously fought so hard during the Patients Bill of Rights to disallow insurance companies from making care decisions, are now pushing this same idea.