Senate Finance Committee Chairman Max Baucus, D-Mont., says that a comprehensive health reform package – due out from his committee within the next week or two – will include plans to compare the effectiveness of drugs and other medical treatments so Americans can answer the question: “What are we getting for our money?”
Such inquiries can be controversial. Critics fear comparisions will be used to ration care, while supporters say targeted research can help patients and doctors select the best options – and help slow rising health care spending.
Speaking at conference held at the Brookings Institution today, Baucus said he will reintroduce comparative effectiveness legislation (.pdf) similar to what he co-sponsored last year with Kent Conrad, D-N.D.
That bill would have created a public-private comparative effectiveness institute to set national research priorities and contract with government agencies and private groups to conduct the evaluations.
Baucus says lawmakers can ease critics’ fears by ensuring that research is “patient focused,” that physicians play a significant role and that decisions are based on clinical evidence about what works best, not solely on cost.
The role of cost-comparisions came up during debate over the stimulus package approved earlier this year. Lawmakers eventually agreed to spend $1.1 billion on comparative effectiveness research.
“I made it clear that it’s not rationing.” Baucus said. “It’s clinical. Is this drug better or not?”
His committee is moving quickly on legislation to overhaul the U.S health system, Baucus said.
“We are on the eve of doing something terrific in America,” Baucus said, describing the effort as “totally inclusive and totally bipartisan.”
Budget Director Peter Orszag, also speaking at the conference, said “too much of health care delivery in the U.S. is not backed by evidence that (one treatment) works better than the alternative.”
While getting better information is very important, Orszag also said lawmakers also have a “moral imperative” to expand access to the uninsured. And any legislation must pay for itself.
“Health reform that will be adopted will be deficit-neutral,” with specific financing proposals that pass muster with “appropriately skeptical” analysts at the Congressional Budget Office, Orszag said. Offsets for the expected cost of covering the uninsured can come from savings in Medicare, Medicaid and by other revenue sources, he said.
Orszag’s comments follow criticism of the administration’s health reform proposals in the media, especially in the blogosphere. Those critics say the administration relies too heavily on unquantifiable or unachievable savings. Orszag responded to those criticisms in his blog, where he also said that the deficit neutrality would come within the next decade.