Effective treatments are not the most profitable, therefore we shouldn’t use them. The market has spoken.
You’d think that doing research to figure out which treatments are most effective would be an obviously good thing. But no: it is, apparently, the first step on the road to socialized medicine. A lot of the attacks rely on this “first step” argument. For instance, the Heritage Foundation wrote that “The type of information collected by CER could eventually be used inappropriately if a “Federal Health Board” was created to decide which types of treatment would be available to whom and when.”
It could be used to do bad things! At least, if a board that doesn’t exist were created and told to use this information! Pass me my smelling salts. I await with eager anticipation the Heritage Foundation’s realization that this very same logic could be used to ban guns: after all, they too can be used to do very bad things, and (unlike comparative effectiveness research) actually are so used. Do you think consistency will oblige Heritage to come out in favor of a ban on all guns? Me neither.
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.
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.
Moreover, once you notice that what the opponents of CER describe as “being deprived of care” just consists in someone’s deciding not to pay for some treatment, the idea that decisions about who gets what treatment are currently made by your physician is true only if you pay for your care out of your own pocket. If, like most of us, you rely on medical insurance, then someone other than your doctor is already making decisions about your care. All CER would do is allow this person to do so on the basis of actual knowledge about what works and what doesn’t.
It seems like a lot of bad policies rely on the idea that it would be a stppeing stone to something else, i.e. Marijuana policy.