CBO+EBM=NICE(USA)

  • by: |
  • 03/04/2007
Very disturbing article about how the new CBO direct appears to be pulling together a panel to apply evidence based medicine (EBM) and cost-effectiveness measures to decide how to squeeze spending out of the the federal health care budget. In essence he is proposing a CBO version of the the UK's National Institute for Clinical Excellence (NICE) with the added feature that unlike NICE, CBO will be in the business of making both clinical and budgetary decisions....

CBO Forming Panel to Examine Slowing
Health Care Cost Growth, Director Says

The Congressional Budget Office is forming a health care advisory group to help CBO craft options for slowing health care growth, with a first meeting set for May, CBO Director Peter R. Orszag said March 2.

In an interview with BNA reporters and editors, Orszag said the panel would be comprised of health care experts such as visiting fellows who will be charged with helping find options to limit health care cost growth.

Orszag in the past has said the advisory panel would be patterned after the CBO's current panel of economics advisers, and also would aid the agency in improving scoring of complicated health care proposals.

Orszag told BNA that rapidly rising health care spending is the biggest threat to the nation's fiscal health. The advisory group will help produce analytical papers on options for curbing rising spending in ways that will not adversely affect Americans' health, he said.


Rising Costs


"We have to take the cost growth out of health care without harming health," he said.

Rising health care costs are more of a threat to the nation's fiscal health than the expected influx of baby-boomers into federal health care programs such as Medicare, he added.

For example, the panel likely will examine such options as the benefits that health information technology and the comparative effectiveness information on medical procedures could have in slowing cost growth, Orszag said.

Orszag said there is a "substantial amount of evidence" that the health care spending has reached "the flat part of the curve" in which increased health care spending is not necessarily producing increased health care benefits.

Which evidence is that? Added quality of life from new drugs for cancer? Alzheimer's? HIV? New vaccines for HPV?

Orszag said he will spend "a very substantial share of my time helping to bend that curve."

How? By using an arbitrary cut of a 50K for a quality of life year like they do in the UK?

Reducing spending in Medicare and Medicaid likely will only shift costs to other parts of the health care system, doing little to sustain the overall health care system or those federal health care programs, he added.

In a budget options paper released Feb. 23, CBO put forward numerous options for trimming federal health care spending. For example, the report said paying Medicare managed care plans the same rate as fee-for-service plans could save $65 billion over five years.

Meaning, we can cut risk adjusted payments for the sickest seniors that are designed to treat them and keep them healthy and integrate their care....


I can't wait to see how many of the panel from from the left wing funded Prescription Project or IMAP. Any bets that Jerry Avorn, supporter of ALLHAT (the modern day Tuskegee experiment) will be annointed?
CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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