Tuesday, August 11, 2009
Questions for your health care town hall: Sec. 1401 and miscellany
This is a statement that runs throughout the 1,100 pages and bothers me every time I see it:By my count, 13 times. I want to make sure you ask this question, and I will make it simple for those worried my questions are too long: Senator/Congressperson, what oversight does the Congress expect to have over decisions of the HHS secretary? Do you have any plans to put more oversight into the bill? Democrats, I expect, will answer yes. But this bill is not amendable into something good. So if you hear them say that, you know they aren't going to do the right thing, which is to kill this thing dead.(4) OTHER INFORMATION.�Such other information as the Secretary may require.
Sec. 1181. (a) Center for Comparative Effectiveness Research Established-It runs on for pages defining an oversight committee, composition of the committee, terms and compensation, etc. The oversight committee, called the "Comparative Effectiveness Research Commission" will disseminate "the findings of research conducted and supported under this section that enables clinicians, patients, consumers, and payers to make more informed health care decisions that improve quality and value." That "and payers" part I emphasized because that includes the government and its new Health Choices Administration.
`(1) IN GENERAL- The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research (in this section referred to as the `Center') to conduct, support, and synthesize research (including research conducted or supported under section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003) with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.
`(2) DUTIES- The Center shall--
`(A) conduct, support, and synthesize research relevant to the comparative effectiveness of the full spectrum of health care items, services and systems, including pharmaceuticals, medical devices, medical and surgical procedures, and other medical interventions;
`(B) conduct and support systematic reviews of clinical research, including original research conducted subsequent to the date of the enactment of this section;
`(C) continuously develop rigorous scientific methodologies for conducting comparative effectiveness studies, and use such methodologies appropriately;
`(D) submit to the Comparative Effectiveness Research Commission, the Secretary, and Congress appropriate relevant reports described in subsection (d)(2); and
`(E) encourage, as appropriate, the development and use of clinical registries and the development of clinical effectiveness research data networks from electronic health records, post marketing drug and medical device surveillance efforts, and other forms of electronic health data.
- What will you do with the results of the Comparative Effectiveness Research Commission?
- Will these results be used in redefining the qualified insurance package I can get? That is, suppose my insurer looks at those results and doesn't change funding for certain treatments. Will the government make them do so?
- There are private groups doing comparative effectiveness research. Insurers no doubt do much of this. Why do we need a government agency to do it? Is this a good use of our money?
- Relatedly, wasn't there a billion spent on this in the stimulus act?
- To what extent will the commission consider cost in its analysis? Uwe Reinhardt, an advisor during the Hillarycare debate, wrings his hands over people spending too much on their health care. Do you worry about this?
- Do you have any evidence that this will save money? CBO says not before 2019.
Labels: economics, health care