The one sort of government spending every Congressman seems to support is medical research, so the budgets of the NIH and other health research bodies reliably go up every year. But Republicans have found one kind of health research they don't like, which is
research into what kinds of medical care actually work. This seems important to Democrats like me because we have little idea how well much of the health care we give to Americans works; according to one widely cited estimate, only half the health care Americans receive is backed by scientific research:
The good news is that the federal government is now making a significant investment in health services and patient-centered outcomes research to identify waste and improve the safety, effectiveness and quality of care. The bad news is that House Republicans are trying to abolish one of the main agencies carrying out this research, the Agency for Healthcare Research and Quality (AHRQ), and cut the funding of another, the Patient-Centered Outcomes Research Institute (PCORI).
As to why, well, you have probably already guessed: because effectiveness research is an Obamacare-driven scheme to cut off the care of your grandmother if it doesn't meet the arbitrary standards of loveless bureaucrats in Washington:
Federal investment in this research (although it predated the 2008 election) became closely tied to the Obama administration’s health-care reform agenda, because big funding increases were tucked into the 2009 stimulus legislation and the Affordable Care Act — two measures the GOP strongly opposed. An increased federal role in comparative effectiveness research, together with payments to physicians for voluntary counseling to Medicare patients about end-of-life options and the creation of the Independent Payment Advisory Board (another agency the GOP wishes to kill) contributed to the “death panels” myth, which Republicans have used to frame health-care reform as “rationing.”
Sigh. This is the sort of thing that makes scientifically-minded people think wistfully about a benevolent dictatorship.
"As to why, well, you have probably already guessed: because effectiveness research is an Obamacare-driven scheme to cut off the care of your grandmother if it doesn't meet the arbitrary standards of loveless bureaucrats in Washington"
ReplyDeleteThat's the reason they cite, anyway.
The real reason is money - specifically the massive pharmaceuticals industry, and the various deals and campaign contributions that they arrange behind the scenes. They help certain politicians get into office, and in exchange those politicians are expected to use their influence to protect the bottom line.
When a drug is selling well despite not necessarily having a particularly solid scientific basis for its effectiveness, the last thing these companies want is government interference. So they invest in buying votes, because it's far cheaper to get important politicians in your pocket than it would be to have to pull a product that doesn't actually do much.
When your profit margins are 30% and you make over $10 billion a year, a few million here and there to maintain the status quo is a steal. And when you're a career politician looking to run for office, it's a lot more desireable to pull strings and look the other way once in office than to risk not getting elected due to lack of funding and support.
It's a dirty game that uses the health and wellbeing of millions of people as a poker chip - but there are plenty of people who will tell you without batting an eye that it's "just the price of doing business".
Actually the Times piece makes a nod in that direction, noting that surgical groups worked to kill one such program in the 1990s after it found that surgery for back pain was not very effective.
ReplyDeleteIt has become an entrenched belief in America that bureaucrats should stay out of health care, which should be left to the patient and his or her doctor, but I think that is ultimately unsustainable. We need somebody to ask what really works and direct money toward that.