In this essay, I write

the effectiveness of activist medicine can only be judged in a statistical sense. To know whether the procedures were appropriate, you have to know the distribution of outcomes that occurred when those procedures were used in many similar cases. The issue is not whether patient A obtained relief, but whether the procedures followed in diagnosing and treating patient A were those that best balanced the probabilities of safe and successful treatment with the cost.

My proposal is that either a consortium of health insurance companies or the government establish a formal mechanism for evaluating the benefits of medical practices. Call this a Medical Guidelines Commission (henceforth the Commission).

My thinking is that decisions in health care can be decentralized, but information needs to be more centralized, so that patients and doctors have a statistical fact base to use for their decisions.