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July 31, 2007

Hear Ye. Hear Ye (Not).

by Peter Pitts

Courtesy of OpinionJournal - Best of the Web yesterday by Jim Taranto.

Great Moments in Socialized Medicine

Englishwoman Olive Beal has a hearing problem. According to London's Guardian, she "finds it difficult to hear with her five-year-old analogue [hearing] aid and needs a digital version that cuts out background noise and makes conversation easier."

Mrs. Beal went to the Eastern and Coastal Kent Primary Care Trust, her local office of the National Health Service. No problem, they told her, she'll get a hearing aid. But it'll take her 18 months to get to the top of the waiting list:

Mrs Beal, a former piano teacher who was involved in the suffragette movement, would be 110 by the time she gets her new hearing aid. "I could be dead by then," she said yesterday.

My comment: Sounds like a strategy -- a dangerous one.

Posted by peterpitts at 11:48 AM
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July 30, 2007

AHRQ Angels

by Peter Pitts

"Mr. Dingell (for himself, MR. RANGEL, MR. STARK, and MR. PALLONE) introduced the following bill; ..."

Thus begins SCHIP legislation so dangerously flawed that it's hard to know where to start.

But since we have to start the debate somewhere, let's start with Sections 904-906.

Sec. 904. Comparative effectiveness research. Establishes within the Agency of Healthcare Research and Quality a Center for Comparative Effectiveness Research to conduct research on the outcomes, effectiveness, and appropriateness of health care services.Also establishes an independent Comparative Effectiveness Research Commission to set priorities and ensure credibility for the Center’s work. It also establishes a Comparative Effectiveness Research Trust Fund, initially funded through the Medicare trust fund, to support the work of the Center and the Commission.

Translation: DERP on a national level courtesy of the AHRQ Angels. Evidence-based medicine without any good evidence. General population studies inappropriately used something they were not designed for --comparative effectiveness

Sec. 905. Implementation of health information technology (IT) under Medicare. Requires CMS to develop a plan to implement a health information technology system for Medicare.

Translation: A system akin to many in the EU (i.e., NICE) where reimbursement decisions are made on a cost-based, rather than a patient-centric matrix.

Sec. 906. Development, Reporting, and use of health care measures. Requires the Secretary to designate a single national entity to coordinate development of health care measures

Translation: The next step towards price controls and choice controls -- not to mention a further slide towards the enshrinement of practice variation over patient variation.

No matter how you cut it, evidence-based medicine based on bad evidence is bad medicine. This language disintermediatesphysicians, hurts patients and helps nobody other than payors (both public and private).

How about this -- let's keep our eye on the prize and reauthorize SCHIP for the population it has always been intended to serve, our nation's neediest children.

Posted by peterpitts at 05:31 PM
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