Having a medical comparative effectiveness council is fine so long as it is advisory at least until American voters have a chance to see how well it is working. And it should include among its members patients, nurses and other medical practitioners. The people who work directly with patients will be indispensable to comparative effectiveness considerations. The make-up and parameters of such a council will be important.
Anyone who is a researcher knows the difficulty involved in sampling and that research, in most areas, is for some time an ongoing process of contradictory findings leading to recommended next steps but rarely definitive conclusions. They know, too, that research regarding one population does not necessarily apply to another, that conclusions are based on statistical significance, not on individual variations that might be explained by research if it doesn't end with what seems the best answer for the most people.
Research is also influenced by paradigms. The hypotheses we generate are affected by ways of seeing - frames of reference. At times these actually impede rather than facilitate progress toward consensus. This does not render research useless by any means, but those relying on it should know the limitations.
It's critical, therefore, not to suggest that Americans must choose between the far right and universal health care as if any criticism or caution of process regarding the latter renders one immediately in the former camp. I thought we'd put behind us my-way-or-the-highway governing.
Universal health care is critical. Let's make it happen. But let's achieve it by being candid. For example, if indeed this council will not be influenced by cost considerations, then why did David Axelrod say on Meet The Press that the following with regard to the council?
We have to get a hold of this issue of cost. It has nothing to do with the, the patient-doctor relationship, it has to do with making our health care system more efficient so it doesn't implode.
If the goal of this council is only greater consistency and accuracy in doctor advice where achievable, it is possible that the findings will cost more. We may find the best procedures are the costliest. Would that be okay?
Let's be honest here. The important thing is to be sure that while we're endeavoring to achieve universal health care, we don't do so only or largely on the backs of ill people but look into the actions of pharmaceuticals, their endless lobbying, their questionable relationships with many doctors and legislators, the legitimacy of skyrocketing costs for procedures and doctor visits, and the outside influence on research findings supported by pharmaceutical companies.
What are we doing there, Dr. Dean? That wouldn't put the onus of successful universal care on patients alone but rather on those who purport to be helping them. That would be real change.
Dr. Reardon also blogs at bardscove