{"id":4414,"date":"2011-03-07T21:26:03","date_gmt":"2011-03-08T02:26:03","guid":{"rendered":"http:\/\/onthe8spot.com\/?p=4414"},"modified":"2011-03-07T21:26:03","modified_gmt":"2011-03-08T02:26:03","slug":"repost-comparative-destructiveness-nytimes-com","status":"publish","type":"post","link":"http:\/\/onthe8spot.com\/index.php\/2011\/03\/07\/repost-comparative-destructiveness-nytimes-com\/","title":{"rendered":"rePost:: ::Comparative Destructiveness – NYTimes.com"},"content":{"rendered":"

March 7, 2011, 12:15 PM
\nComparative Destructiveness
\nJonathan Chait gets angry at the way Republicans, who claim to care about the deficit, propose saving money by cutting back on expenditures that are needed to control health costs. Indeed. But there\u2019s a larger dynamic at work here than mere stupidity.
\nLet\u2019s focus, in particular, on the ridicule some of the quoted Republicans heap on \u201ccomparative effectiveness research.\u201d
\nAsk yourself, what do we have to do to control Medicare costs? We can save some money, maybe a lot, by reforming payment systems so that providers are paid for overall treatment rather than on a fee-for-service basis. But over the long term, the fundamental issue is going to be to decide what Medicare will and won\u2019t pay for. We need, as Henry Aaron has often said, to learn how to say no.
\nNotice that this is very different from the issue on Social Security. You can propose simply cutting retirement benefits by 25 percent, and that\u2019s doable. But you can\u2019t decide to do only three-quarters of every operation and test that Medicare pays for (and no, you can\u2019t demand that patients pay 1\/4 of the cost without effectively denying care to many Americans.) So Medicare cuts are an inherently harder problem than SS cuts. In fact, I suspect that\u2019s one reason, beyond the political motivations, why inside-the-Beltway types love to talk about Social Security, a trivial concern, while avoiding the vastly more important Medicare issue.
\nSo how are you going to make decisions about what not to do? Um, you need good information about which medical interventions work, and how well they work: comparative effectiveness research. And no, that information isn\u2019t already out there: doctors know surprisingly little about how effective procedures are relative to one another.<\/strong>
\nWhy, then, are Republicans opposed to this kind of research? Some of it is sheer stupidity and\/or anti-intellectualism \u2014 hey, those researchers are probably atheistic Democrats, you know.
\nvia Comparative Destructiveness – NYTimes.com<\/a>.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

March 7, 2011, 12:15 PM Comparative Destructiveness Jonathan Chait gets angry at the way Republicans, who claim to care about the deficit, propose saving money by cutting back on expenditures that are needed to control health costs. Indeed. But there\u2019s a larger dynamic at work here than mere stupidity. Let\u2019s focus, in particular, on the … <\/p>\n

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