Every lobbyist swarming Capitol Hill these days knows that, when it comes to legislation, the devil is always lurking in the details, not lounging in the concepts. Yet concepts, not details, are drifting down to the public—who will be in for a surprise when they realize that reform is not what they think it is. How these details are hashed out, or slipped into a bill at the eleventh hour is crucial to the success or failure of reform. This is the sixth of a series of occasional posts that will look at where the devil lies in key provisions of the health care bill. The entire series is archived here.
Bill Clinton’s heart stents gave Fox News a chance to take a whack at health reform. This time the issue was comparative effectiveness, which means systematically comparing, based on scientific evidence, how effective two or more treatments are in treating disease. While this sounds straightforward enough, comparative effectiveness is not a slam dunk. Supporters promise that it will save money, a prediction that may or may not come true. Some doctors, who are used to raking in big bucks from ineffective treatments, aren’t keen on the idea. Neither are right-wing ideologues who use comparative effectiveness to invoke the specter of rationing and to whip up hysteria against reform in general. Pity the poor patient denied some advertised life-saving treatment, even if its efficacy is questionable!
That’s the line that Fox took the other day, implying rather clumsily that the former president might not have gotten his stents if the Democrats’ health reform “had gone through.” Fox & Friends host Brian Kilmeade got right to his point by asking the network’s legal analyst, Peter J. Johnson, Jr., if Clinton would have gotten his stents. “I do think under a lot of protocols, he would have gotten those stents,” Johnson replied, and then quickly moved to the “what if” part of the conversation. He cited the sums the government plans to spend on comparative effectiveness research—the $1.1 billion called for by the stimulus bill and the nearly $300 million requested in President Obama’s budget—which could create, he said, “best practices, a standard of care.” Johnson went on, getting in his licks about the Obama crew:
If the government decides to adopt the Peter Orszag, budget director, architect of health care, method and put in regulations that say there is a gold standard, there is a best practice based on the literature, perhaps hundreds of thousands of people like the president.