The following editorial appeared in the St. Louis Post-Dispatch on Wednesday, Feb. 25:

Conservative commentators – Rush Limbaugh, Lou Dobbs and Glenn Beck among them – have been railing against a provision in the federal stimulus bill that funds research into how well medical treatments actually work and distributes the results to doctors and patients.

With national health spending expected to reach an average of $8,160 for every man, woman and child in the country in 2009 – with study after study showing that the quality of American health care is uneven, at best – finding out what works and what doesn’t is crucial. Such research probably will play a big role in President Barack Obama’s health-care reform plans.

But where others see common sense and a businesslike approach to improving quality and controlling costs, some conservatives see conspiracy. Limbaugh warns darkly that comparing the effectiveness of health treatments really is just the first step toward health-care rationing and government-controlled medicine.

Never mind that health care already is rationed in the United States on the basis of price. Never mind that knowing the utility of goods and services offered for sale is the cornerstone of free-market economics, essential to determining their value. Never mind that the rationing assertion is borrowed wholesale from a flawed analysis by Betsy McCaughey, a former Republican lieutenant governor of New York, who works for a think tank funded in part by the drug industry.

Misrepresentation of so-called “evidence-based medicine” has become something of a Republican Party talking point.

Comparing the effectiveness of medical treatments is the central principle of scientific medicine and the key to all modern quality improvement efforts.

The federal government began doing it because it is by far the nation’s largest buyer of health care. Not knowing what works means paying for less-than-optimal quality.

Large employer groups, who foot the bill to provide health insurance to workers, have been doing it for decades. So have insurance companies. That’s why, no matter how much your doctor may want to give you an experimental treatment – Laetrile for cancer, say – your insurance won’t pay for it. Laetrile doesn’t work, so this is a very good thing.

So who would oppose improving health quality and reducing waste? Some drug and medical device makers worry that testing will show their ultra-expensive new products aren’t much better or any better than existing alternatives.

And then there are politicians and pundits with nothing to offer but bankrupt ideas and no way to sell them but fear itself. Megadittos.


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