Comparative effectiveness institute makes it into final health care bill
The Democratic health care bill enacted into law keeps President Barack Obama's promise to "establish an independent institute to guide reviews and research on comparative effectiveness to provide accurate and objective information."
Comparative effectiveness research measures medical treatments by their rates of success and their cost-effectiveness.
The new law replaces an existing comparative effectiveness coordinating council created by the 2009 economic stimulus bill with what's now called the Patient-Centered Outcomes Research Institute. The new entity will set priorities and conduct research. It will be independent, governed by a board of experts and stakeholders, and funded by transfers from federal trust funds. The research will be peer-reviewed and made public.
Supporters say that such research could lower costs by advising against expensive procedures that don't improve people's health. But critics have suggested that the effort could lead the United States down a slippery slope in which experts insert themselves between doctors and patients and micromanage what treatments should be used -- especially with regard to end-of-life decisions.
Faced with such concerns, the bill's authors took special care to require any findings to be advisory only, rather than being binding on doctors or insurance companies.Responding to the critics' allegations of "death panels," the law prevents the use of any findings "in a manner that treats extending the life of an elderly, disabled, or terminally ill individual as of lower value than extending the life of an individual who is younger, nondisabled, or not terminally ill."
All in all, the newly established institute closely fits the terms of the president's campaign promise. We consider it a Promise Kept.
Text of H.R. 3590, the Patient Protection and Affordable Care Act, accessed April 7, 2010
Kaiser Family Foundation, "Side-by-Side Comparison of Major Health Care Reform Proposals," accessed April 7, 2010
Science Careers Blog (Science magazine), "Comparative Effectiveness Research Boosted in Health Care Bill," March 22, 2010
Health bill includes formation of a Center for Comparative Effectiveness Research
After months of talking about health care reform, the U.S. House of Representatives introduced major legislation to overhaul the nation's health care system. House Democrats unveiled the 1,000-plus-page bill, called America's Affordable Health Choices Act of 2009, on July 14, and it includes most of President Barack Obama's key proposals on health reform.
One of Obama's campaign pledges was to create a center for comparative effectiveness, to study and promote the most effective types of health care. Obama and his budget director Peter Orszag have spoken often about how they believe such research could lower costs by advising against expensive procedures that don't improve people's health.
The House bill creates the Center for Comparative Effectiveness Research and pays for it though a fee on private insurance.
We should be clear that there's a long way to go — maybe months — before this bill becomes law. It has to get through the Senate, where many an ambitious House bill has seen its hopes dashed.
Nevertheless, the bill marks significant, measurable progress on Obama's promise, and we rate it In the Works.
Thomas, HR 3200 , introduced July 14, 2009
U.S. House of Representatives Energy and Commerce Committee, House Democrats Introduce Bill to Provide Quality, Affordable Health Care for All Americans , July 14, 2009
Office of Management and Budget Blog, McAllen Redux , by Peter Orszag, June 4, 2009