Stimulus initiative stirs up controversy

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Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

In the Los Angeles Times, Noam N. Levey reviews the controversy that broke out when President Obama included money in the stimulus plan to study what medical treatments are most “cost effective.”



As Levey writes, “Many healthcare authorities and policymakers have agreed for years that a better system for tracking how well drugs, medical devices and surgical procedures work could improve the care Americans receive and ultimately save billions of dollars.”

The fight over what Levey calls “a relatively obscure proposal” foreshadows arguments that health care reform advocates can expect to face as Obama moves forward with plans to overhaul the health care system.

“The comparative-effectiveness issue was supposed to help lay the groundwork for the broader reform effort. But it became a lightning rod for conservative commentators who labeled it a step toward socialized medicine, a line of attack that has doomed every health overhaul effort since World War II.”

2 thoughts on “Stimulus initiative stirs up controversy

  1. Andrew Holtz

    For a long time public discussion of health care reform… including many news reports… used “universal coverage” and “single-payer” as nearly synonymous… when of course they are not.

    Now we are seeing “cost-effectiveness” and “comparative effectiveness” treated as synonyms. They are related, but not the same thing. A drug, for example, that is the most clinically effective in its class, may or may not be the most cost effective, depending on the price.

    For several years, the Drug Effectiveness Review Project (DERP) ( has been comparing the clinical evidence of similar drugs for more than a dozen state Medicaid programs and others. The reviews don’t look at cost. They just provide summaries of what’s known about the health effects of the drugs. Then it’s up to policymakers in each state to determine the benefit package.

    It’s no surprise that when two drugs provide similar benefits, state officials may give preference to the less costly one… but that’s a separate process… and different states take different actions based on the very same DERP reports.

    Some advocates will intentionally mix-up terms when confusion suits their policy agendas. We have to guard against letting the fog get into our writing.

    It’s important that our stories use words precisely. Mingling similar, but distinct, concepts will confuse our audiences… and muddy the public discussion.

  2. Pingback: Study advocates evidence-based medical guidelines : Covering Health

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