About $1.1 billion of the economic stimulus package just approved by Congress is devoted to comparing the merits and risks of the differing treatment options a patient and physician face when determining the best course of medical care for any given condition. The comparative program’s mission is to provide the properly documented value of drugs, medical devices, surgical procedures, and other treatment options so more-informed decisions can be made. There is also the expectation that treatment comparisons will discourage the use of expensive treatments when less expensive options prove more effective.
A council of as many as 15 federal employees will be chartered to coordinate research, initiate comparative studies, and advise President Obama and members of Congress on the most effective ways to invest the $1.1 billion. Similar councils are in effect in England, France, and other countries around the world. The US Health and Human Services Department will oversee the program and the financial expenditures it suggests.
Advocates of the bill look to it as a means of saving both money and lives. Others cite the program as a means of reining in the $2.2 trillion per year spent on health care in the US. While healthcare spending currently accounts for about 16% of the nation’s gross domestic product (GDP), expectations are that healthcare spending will climb as high as 25% by 2025 if better means of control aren’t established.
Proponents, including pharmaceutical and medical devices manufacturers, say the program will merely ration health care, perhaps detrimentally, and take medical decisions out of the medical community and into government control.
Another concern over the program is the imbalanced proportion of medical studies conducted on mostly white, male subjects. White women and minority patients of both genders often achieve different results from a specific treatment than those found in medical studies on white men. As these gender and ethnic differences become more apparent under a broader scope of study, the medical scientific community has taken these variations into consideration but the predominance of studies on white men is still an issue. The council will have the power to conduct broader testing to identify and address these variations.
While monies will be funded immediately, the council has several years to spend the full amount. In the meantime, discussion is under way to determine how this new regulation, requiring comparative analysis of medical care, will work under the existing Medicare program and to what degree alterations to that program need to be made.
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