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May 12 2009

Hilzoy Cuts to the Heart of CER

You’re going to hear quite a bit of insane frothing blather over “Comparative Effectiveness Research” from Cons. Y’see, they don’t want objective folks making scientific determinations of whether insanely expensive medical treatments, devices and drugs are effective compared to cheaper treatments, etc. That would mean that corporations couldn’t make insane profits, and we can’t have that.

So they’ll pull out all the usual stops. They’ll bring out the Big Gubmint Boogeyman:

On January 23, Representative Tom Price (R-GA), a physician, sent out an “alert” through the Republican Study Committee, falsely warning that the CER legislation would create “a permanent government rationing board prescribing care instead of doctors and patients.” The true intent of the CER provision, Price warned, was “to enable the government to ration care” (emphases in original). “Every policy and standard will be decided by this board and would be the law of the land for every doctor, drug company, hospital, and health insurance plan.”

Make shit up:

Parallel arguments appeared in a letter sent January 26 to several influential members of Congress, cosigned by more than 60 advocacy groups, and again in a January 29 editorial in the Wall Street Journal. In an op-ed by columnist George Will that appeared in the Washington Post the same day, CER had morphed from a form of research into an imaginary new federal body with broad powers. Will named the agency “the CER” and claimed that with such a system, “Congress could restrict the tax exclusion for private health insurance to ‘insurance that complies with the Board’s recommendation.’…”

And go for a Godwin:

But the Heritage Foundation is a marvel of sanity and good sense compared to John Griffing in the American Thinker, who describes the language providing for CER as “a line that would sentence millions of people to death”, and adds, by way of explanation: “If you are picturing Germany circa 1930, you’re right on. With the passing of this bill, government, not doctors, will decide who receives care and who doesn’t, in essence, who lives and who dies.” Deacon for Life, for his part, calls it “Mengele-esque”. The idea that Hitler and Mengele’s great sin was conducting research into the comparative effectiveness of various medical treatments is, shall we say, peculiar.

Hilzoy notes all of the above, and then cuts to the heart of the matter:

More seriously, there is something about the arguments against CER that I have never understood. The opponents of CER claim that it will inevitably be used to make decisions about care. Insurers will not want to pay for care that is not effective, and so people will be deprived of the care they need. But notice what “deprived of care” means here. No one is seriously proposing to make it illegal to purchase whatever medical care you want on your own.

This means that even if your insurance company decides that it will not pay for some treatment that has been shown to be ineffective, you will, under any proposal being seriously considered, still be able to get that care; you just won’t be able to get someone else to pay for it. If not having someone else pay for your medical care counts as being “deprived of care”, then 46 million people are being deprived of care even as we speak — and that’s just the uninsured; it doesn’t include people who have insurance that doesn’t cover the treatments they need. And yet, strange to say, the opponents of CER generally do not see this as a problem.

Nope. Cuz, y’know, if private insurance companies deny treatment, that’s like totally okay. And who wants poor people to have medical care, right?

What the hysteria really comes down to is the Cons’ belief that private industry should have free rein to lie, cheat, and steal. They’re terrified of government-backed scientific research because that would put an end to all the fun.

Remember that when they try to spin CER as some kind of socialist Nazi government takeover of what little healthcare you currently enjoy.