Thursday, April 23, 2009

Another example of how Republicans are scared of science

In a Washington Post story about the delay in confirming Kathleen Sebelius due to Republican concerns, one paragraph caught my eye.

Sen. Jon Kyl (R-Ariz.) opposes Sebelius because of the Obama administration's support for research on the comparative effectiveness of disease treatments. He said he fears the evidence-based approach, coupled with information on price, could lead to rationing of care.
Wow, absolutely unbelievable.  WTF?  Science and facts can be scary and make us face the hard truth that America isn't perfect which scares Republicans so much that they try to frighten us into ignoring science or as they call it "schmience".  Isn't the free market blindly espoused by Republicans suppose to be all about transparency so consumers and businesses can make the right decision.  Sure health care could be rationed or regulating emissions could destroy our economy but the country is much more likely to benefit from science.  

I know that when I go to the doctor I want the doctor to have as much information as possible on the best ways to treat me.  Quite a bit of research has been done documenting regional differences of the quality of health care and how some doctors prefer treatments they are familiar even when they are not the most effective.  From an article in Time by Michael Grunwald entitled "How Obama is Using the Science of Change":
More information can make us healthier too, which is why the stimulus poured $1.1 billion into "comparative effectiveness" research. Orszag has reams of charts showing that medical tactics and costs vary wildly across the country, with little regard for what works. He'd like to document best practices — from emergency-room to-do lists that dramatically reduce infections to protocols for when pricey tests and surgeries really help — and then have all medical providers adopt them. This approach has helped American anesthesiologists reduce deaths as well as costs.   
What Republicans will probably point to when arguing against comparable effectiveness research is how the UK's National Institutes of Health and Clinical Excellence judges the cost effectiveness of therapies.  From a Harvard Business School blog post:
For years, the UK's National Institutes of Health and Clinical Excellence (NICE) has decreed whether certain therapies are more effective than others. It has gone so far as to judge the cost effectiveness of such interventions, e.g. that prolonging life for 6 months for $100,000 isn't worth the expense. The US government won't provide cost effectiveness edicts (at least not directly — payors will interpret the data and make their own decisions), but it will sponsor head-to-head trials.

Traditionally, therapies have been judged against placebos, which is not a very realistic comparator. This (comparable effectiveness research) is good news for medicine, but it is likely bad news for many drugs and devices
I don't think many people are arguing that the U.S. government tell us if a certain treatment is not worth living a few months but rather making sure that all health care participants have the appropriate information to reduce negative outcomes.  Don't let Republicans get away with scare tatics to eliminating effectiveness research.

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