Mike Kueber's Blog

August 21, 2012

Medicine that works

Filed under: Medical — Mike Kueber @ 3:41 am
Tags: , ,

Today’s New York Times includes a fascinating op-ed piece by H. Gilbert Welch on wasteful medical expenditures.  The article points out that the economics in the American medical industry create tremendous incentives for the development of medical products and services that are effective in treating medical problems.  Unfortunately, there are virtually no incentives for identifying products and services that do more harm than good. 

Because of this mismatch of incentives, Welch argues that Americans waste vast amounts of money on medical products and services that don’t work.  The two poster examples of this waste are (1) hormone replacement therapy to healthy middle-aged women and (2) P.S.A. screening for prostate cancer to older men.  Both of these treatments were widely accepted and used in the 90s, but then since the turn of the century, both have been determined by trial studies to have dubious value.

Although ObamaCare attempted to address this problem by creating the Patient-Centered Outcomes Research Institute to study the comparative effectiveness of different treatments, Welch is convinced that the Institute’s budget is wholly inadequate. 

Welch should be grateful that there is any budget to do this work after the Republican Party successfully demagogued this issue.  The Republicans piously whine that ObamaCare is inserting a government bureaucrat between individuals and their doctors.  I say that government is failing miserably if it blindly spends money on medical expenditures without ensuring that the purchased treatments are effective. 

I blogged about comparative-effectiveness research more than a year ago, and argued at that time that government bureaucrats should also look at cost-effectiveness.  Because of the mismatched incentives in the medical industry, this type of review needs to be performed by government. 




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