Comp. effectiveness promises better, cheaper health care but cricits link it to rationing

"Federal health agencies, seeking to hand out stimulus funds to research the effectiveness of various medical treatments, said they will include projects that look in part at the cost of drugs and other treatments.

The approach -- which was unveiled in a report to Congress this week by the Agency for Healthcare Research and Quality and the National Institutes of Health, both agencies under the Department of Health and Human Services -- could provide more fodder to conservatives worried that the government might use the results of such studies to limit health care to consumers," the Wall Street Journal reports.

The agencies will spend about $700 billion on the comparative effectiveness research over the next two years. AHRQ will target arthritis, cancer, and 12 other conditions that require expensive treatments. NIH says it has 1,800 pending research applications, but has yet to determine which count as comparative effectiveness research (Zhang, 7/31).

Broader research shows that treatments, quality outcomes, and cost vary widely between regions and even specific hospitals. "No two hospitals are alike, according to a trove of evidence showing that the quality and cost vary dramatically from one place to another," USA Today reports, adding that Don Berwick, of the Institute for Healthcare Improvement notes "these communities appear to share a 'sense of moderation' that places the interests of patients above competition for market dominance; they rely more on primary care doctors and share a culture of quality that leans heavily on data to evaluate medical performance." However, hospitals that engage in data driven efforts to cut back on costs, and members of Congress that support such efforts, open themselves up to accusations of "rationing," Len Nichols, an economist at the New America Foundation pointed out (Sternberg, 8/2).