You may have heard or read some glaring inaccuracies during the debate over the stimulus bill, specifically widespread reports and commentaries that mischaracterize some provisions of the package pertaining to health information technology (HIT) and to comparative effectiveness research. Here's the truth:
According to an American Medical Association analysis, the bill does not create a federal system for electronically tracking patients' medical treatments or for monitoring compliance with federal treatment standards. While it imposes financial penalties for those who do not adopt HIT in the next six to seven years, those penalties bear no relation to individual treatment decisions made by physicians. Further, the bill does not create a single new bureaucracy to determine whether treatments are appropriate or cost effective. In fact, it reinforces provisions in current law that prohibit the secretary of health and human services from including mandates establishing national clinical guidelines or national coverage decisions in clinical comparative effectiveness research.
A joint statement from the House-Senate conference committee on the stimulus package clearly states the bill's intent: "The conferees do not intend for the comparative effectiveness research funding included in the conference agreement to be used to mandate coverage, reimbursement, or other policies for any public or private payer. The funding in the conference agreement shall be used to conduct or support research to evaluate and compare the clinical outcomes, effectiveness, risk, and benefits of two or more medical treatments and services that address a particular medical condition. Further, the conferees recognize that a 'one-size-fits-all' approach to patient treatment is not the most medically appropriate solution to treating various conditions and include language to ensure that subpopulations are considered when research is conducted or supported with the funds provided in the conference agreement."
Where did the inaccuracies come from? Most flow from former New York Lt. Gov. Betsy McGaughey and a commentary she wrote for Bloomberg.com. The allegations in her commentary were picked up and quoted as fact by Fox News, the Drudge Report, and radio commentator Rush Limbaugh.
Action , Feb. 16, 2009