Health care reform bill 101: Will it make health care more effective?
The new health care reform law sets up a nonprofit organization to direct research on finding the most effective ways to maintain or restore patient health.
Washington — Buried within the massive new US health care reform law is a small provision that in years to come could have a major effect on the kinds of treatments that American patients receive.
The provision requires the federal government to set up something called a “Patient-Centered Outcomes Research Institute.” It sets aside $500 million in seed money for this new nonprofit organization, which is supposed to become a national guiding force for comparative effectiveness research.
What’s that? Simply put, comparative effectiveness research takes a particular health problem, then pits different ways of treating that problem against one another, in an attempt to find which, if any, is a more effective way to maintain or restore patient health.
(Yes, it does sound a little like “American Medical Idol,” doesn’t it? But let’s not trivialize a serious subject.)
It’s true that the point here is to save money as well ensure successful outcomes for patients. Supporters of comparative effectiveness research believe it’s a no-brainer way to figure out whether cheaper drugs, medical devices, or surgical techniques work just as well as fancy, expensive ones.
Prices for medical care stay low, patients and insurers pay less, so the cost curve of healthcare gets bent downward. Everything would be good, right? And in fact, the US already funds lots of research in this area. There was more than $1 billion for grants for comparative effectiveness studies in the stimulus package, for instance.
The new centralized organization funded by the health reform law simply is supposed to be a headquarters for this effort, by directing studies, then synthesizing and disseminating results.
Not so fast, say opponents. They worry that this whole thing could lead to rationing of care – particularly new, expensive treatments.
That is why the just-enacted health reform law also contains language saying that findings from this new institute can’t be construed as mandates for particular treatments, and can’t be used as an excuse to deny coverage of particular treatments.
The new institute will be run by a 19-member board of directors chosen by the US Comptroller General. It is supposed to be up and running within six months.
Health Care Reform Bill 101:
Introduction: What the bill means to you
Part 1: Who must buy insurance?
Part 2: Who gets subsidized insurance?
Part 3: What's a health 'exchange'?
Part 4: How long will reform take?
Part 5: Who will pay for reform?
Part 6: What will it mean for business?
Part 8: What does it mean for seniors?
Part 9: Rules for preexisting conditions