Thus begins SCHIP legislation so dangerously flawed that it's hard to know where to start.
But since we have to start the debate somewhere, let's start with Sections 904-906.
Sec. 904. Comparative effectiveness research. Establishes within the Agency of Healthcare Research and Quality a Center for Comparative Effectiveness Research to conduct research on the outcomes, effectiveness, and appropriateness of health care services.Also establishes an independent Comparative Effectiveness Research Commission to set priorities and ensure credibility for the Centerâ€™s work. It also establishes a Comparative Effectiveness Research Trust Fund, initially funded through the Medicare trust fund, to support the work of the Center and the Commission.
Translation: DERP on a national level courtesy of the AHRQ Angels. Evidence-based medicine without any good evidence. General population studies inappropriately used something they were not designed for --comparative effectiveness
Sec. 905. Implementation of health information technology (IT) under Medicare. Requires CMS to develop a plan to implement a health information technology system for Medicare.
Translation: A system akin to many in the EU (i.e., NICE) where reimbursement decisions are made on a cost-based, rather than a patient-centric matrix.
Sec. 906. Development, Reporting, and use of health care measures. Requires the Secretary to designate a single national entity to coordinate development of health care measures
Translation: The next step towards price controls and choice controls -- not to mention a further slide towards the enshrinement of practice variation over patient variation.
No matter how you cut it, evidence-based medicine based on bad evidence is bad medicine. This language disintermediatesphysicians, hurts patients and helps nobody other than payors (both public and private).
How about this -- let's keep our eye on the prize and reauthorize SCHIP for the population it has always been intended to serve, our nation's neediest children.