Special Report

The Hidden Healthcare Horror

A $1 billion matter of life and death in the stimulus package.

By 2.18.09

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Much of the criticism of the $787 billion stimulus bill is focused on its cost. But what's really at issue is a matter of life and death. Buried deep in the package, there is an expensive new healthcare program that could jeopardize the health, even the lives, of millions of patients.

The bill funnels about $1 billion into government-run "comparative effectiveness research" (CER). Sounds innocuous enough -- that's a relatively paltry sum given the package's $800 billion-plus price tag. But CER will have profound effects on the availability of top-notch treatments in this country. Stripped of bureaucratic jargon, it is the precursor for a national healthcare rationing board.

CER basically involves comparing different pharmaceutical drugs, medical devices, and other treatments in order to determine which is most cost-effective for fighting a particular disease. Theoretically, that sounds like a good program. But, in practice, CER will likely be used to justify rationing and restrict patient treatment options.

That's been precisely the result of CER programs in other countries.

Britain's comparative effectiveness agency, the National Institute for Health and Clinical Excellence (NICE), recently denied approval for the osteoporosis drug Protelos. NICE officials claimed that it was too pricey to be covered by the country's public insurance system. Never mind that research shows that Protelos's cheaper alternatives aren't effective for one out of every five osteoporosis patients. Countless Britons will now suffer from preventable bone fractures.

Canada's government-run healthcare system is equally stingy about approving state-of-the-art medical treatments. One recent example: A 57-year-old man living in Alberta went in for treatment for an arthritic hip. A specialist recommended he receive a cutting-edge surgery known as "Birmingham" hip resurfacing. Public bureaucrats denied the man coverage for the procedure, claiming he was "too old" for it. Worse still, they forbade him from paying for the procedure himself on the private market.

Virtually every government-run CER program ends up closing off patient access to the best treatments in the name of "cost consciousness." When bureaucrats are put in charge of medical care, cutting down on bills is prioritized over fighting disease.

So it's imperative that this CER proposal be closely scrutinized and that, at the bare minimum, appropriate checks be put in place to insure the program doesn't compromise patient health. The deeper the government's involvement in the healthcare sector, the more life-or-death decisions are handed over to callous budget analysts instead of individual physicians and patients.

It's important to note that CER wouldn't just determine the care options for patients covered under public health insurance. The program's determinations will affect everyone. The federal government is the single biggest buyer of pharmaceutical drugs in the country. If, based on CER findings, the government decides to stop covering a particular medicine, public programs will stop buying it from its manufacturer. But medical companies will have a hard time turning a profit on a particular treatment if the government isn't a customer, and many will be forced to simply stop producing it altogether.

There are plenty of proposals included in the stimulus package that aren't actually tied to economic recovery. But CER is the only one that threatens the lives of countless Americans. It's too dangerous to be ignored.

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About the Author
Lawrence A. Hunter is president of the Alliance for Retirement Prosperity.