To keep up with the health care reform debates, you’ll need to know what a Federal Health Board does– or rather, could do.
It doesn’t exist yet. But if Tom Daschle can explain away that little tax mix-up (Oops! He just forgot about that $128,000 of taxes. Don’t worry about it, Tom, little six figure mishaps happen to all of us) we’ll be hearing about a Federal Health Board very soon.
The idea is to create a Board that can make fair and logical decisions about what health care interventions the federal government should pay for.
It seems pretty obvious: we want to pay for interventions that actually work. The way you know if a particular intervention works is by studying it — medical research. So we want to pay for drugs and procedures that are backed by solid evidence.
Of course it’s not that simple. There’s good quality evidence and bad, preliminary evidence, evidence that just “suggests” something, conflicting evidence, evidence based on biased research, wishful thinking, faulty logical… you get the idea.
That’s why you can’t just make a computer program and be done with it.
Members of a Federal Health Board would be appointed rather than elected, so it would be easier for them to do the right thing, even if the decision is very unpopular.
Not that long ago, our government tried something like this. Dennis Cotter, who has been assessing medical technologies for almost 30 years now, shares a cautionary tale in a Health Affairs blog. Here’s the really short version:
In 1979, the Department of Health and Human Services created a National Center for Health Care Technology (NCHCT). Their job was to figure out how well medical technologies (old and new) actually worked. They started to do just that, found (surprise!) that some of the technologies we were using a lot were a waste of money. This deeply offended (threatened the livelihood) of some in the health industry, who managed to get the NCHCT budget cut to… zero.
NCHCT
1979-82
RIP
The fear was that, by letting the government decide what should be covered (in federal health care programs) we would end up with socialism.
Well, we certainly have avoided socialism. No doubt about that.
Let’s hope this time around, the idea of the government paying for what works and not paying for what doesn’t work is given a little more consideration. After all, we’ve been trying the alternative for a long time now.
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