FCCCER

[bemused_leftist]

Ah, that was the name of that thing.

President Obama’s Federal Coordinating Council for Comparative Effectiveness Research was sold as simply government helping doctors choose the best treatments. But there are dozens of medical journal review articles that do just that. The real purpose of such councils is ultimately to establish official criteria for denying reimbursement to less favored (because presumably less effective) treatments — precisely the triage done by the NICE committee in Britain [....]
letters@charleskrauthammer.com
washingtonpost.com/wp-dyn/content/article/2009/08/27/AR2009082703262.html

Comments

[kelsied.livejournal.com]

Mmm, I disagree with this particular set of concerns.

There are a lot of medical journal review articles evaluating efficacy, yes. But there is significant value in a public program responsible for evaluating those journal articles and making recommendations about good medical practice.

Right now, this job is being done by the health plans -- those same, profit-driven, corporate entities that have been taking such flack recently for repeated denials of coverage and ... basically ... everything bad that people want to pretend health reform will cause. Health plans ration care, based on committees just like this, only those committees are not necessarily subject to public review, and the evaluations of individual physicians employed by the company whose interests are aligned with the company's profits. The result of this is that Americans get the best care they can individually afford... or that they can wheedle out of the health plans.

Compared with that, I'll absolutely back the creation of a neutral, government sponsored, public-interest driven organization with the stated goal of providing better information to doctors, which will give patients a stronger basis for arguing with their insurance companies about what SHOULD be covered.

Also, there is no proposed equivalent to the QALY in the legislation to create this program, and nobody is proposing anything like a QALY system. Even though it is arguably a more equitable system than distributing scarce resources based on ability to pay (the current American system). And I note that Americans who CAN afford to pay would still be able to get their unequitable and preferential health treatment -- we'd just be providing stronger support to people who don't have that kind of money and who are presently dependent on the questionable good-will of their health plans to get any treatment.

So I'd just be a little skeptical of anyone who wants you to worry about this -- the health industry arguments about health care reform amount to a bit of a shell game. They're trying to make you afraid that the government will do the same kinds of things they've been doing for years, and that they continue to do right up to this very day.

[(Anonymous)]

I'm pretty sceptical of Krauthammer in general. Just making a note of the name of Obama's proposed thingy, which we haven't heard much about lately.

I agree that there's a lot of nonsense going around, and most of the things we're being warned against, the insurers are doing already.

But who is going to staff the FCCCER? That's a lot of eggs in one basket, and won't they have some power over Medicare also?

[kelsied.livejournal.com]

Depends how they structure and fund it. Especially how they fund it. It wouldn't be the first time the same government had separate agencies responsible for administering nearly identical programs for separate constituencies -- for instance, look at CalPERS and CalSTRS in California -- they both operate retirement programs for public servants, but they have separate budgets, authorities, governing law, staffs, resources and decisions. They often decide to work together on things, but there is no guarantee that they will make identical or even consistent decisions on a particular issue.

I imagine no matter what the feds do, they'll have to hire a whole lot more government employees to staff the new program, or to replace the government employees who leave other federal programs to staff the new program. All part of the shuffle... *grins*