May 22, 2018
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A little-noticed benefit of health care reform

U.S. President Barack Obama speaks about Affordable Health Care to volunteers at the Temple Emanu-El in Dallas, Texas, November 6, 2013.


Should you get surgery for your back pain or physical therapy? When is heart surgery preferable to drug treatment? Before too long, you might get some answers.

Doctors, hospitals and researchers often don’t have the information they need to gauge the effectiveness of one test or treatment against another — or against none.

One little-heralded part of President Obama’s health care reform law proposes to change that, possibly transforming medical practice for the better — but also probably inciting renewed political warfare over health-care “rationing.”

In July, the government began collecting a small tax on health insurers and sending the proceeds to the Patient-Centered Outcomes Research Institute, an advisory committee tasked with, basically, rigorous review of what works and what doesn’t. One of PCORI’s latest grants went to set up a research network that will pull in data on patient experiences across the country.

The concept is simple enough. The government should have delved into this sort of research with such ambition many years ago, as health care costs rose steadily above inflation. Yet there are challenges. Maybe a treatment affects women differently from men, or the young more than the old. The statisticians will have to tease out those and other confounding effects. Results will not always be clear.

Even when they are, people will have to be convinced. Many will resist giving up a test or a drug they have come to trust, even if it’s proven ineffective.

PCORI will encounter its share of political dogfights. Removing ineffective treatment from the health care system will be far from painless.

But the alternative should be much less tolerable.

The Washington Post (Dec. 8)

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