Popular Resistance to Cost-Effectiveness Research: Two Stories and a Challenge
By Bryan Caplan
Measuring the cost-effectiveness of medical treatment seems unpopular – especially among conservatives. Why would this be? I have two stories – one fairly charitable, the other not so charitable.
The charitable story. Many people – even people who strongly favor heavy government subsidies for medicine – deeply distrust policy wonks. They fear that these wonks will use cost-effectiveness research to trump the medical decisions they’d like to make in consultation with their doctors (who they do trust). The simplest way to prevent the wonks from usurping patients’ sovereignty is to prevent cost-effectiveness research from happening in the first place.
The not-so-charitable story. Resistance to cost-effectiveness research is yet another expression of the “get your government hands off my Medicare” mentality. Many conservatives (and even some libertarians) have come to equate limitations on Medicare reimbursements with “price controls” and limitations on Medicare covered treatments with “rationing.” Given this perspective, cost-effectiveness research is merely an elitist rationalization for rationing. The simplest way to prevent this rationing is to prevent the rationalization from getting off the ground.
Intelligent liberals rightly see conservatives’ resistance to cost-effectiveness research as ridiculous. Combining government financing with unlimited consumer choice is a prescription for fiscal disaster. Yet I challenge liberals to consider an unwelcome implication: In the United States, government-funded health care tends to be unusually expensive and unusually ineffective. Americans can learn to love government financing of medical care. They’ve been doing it for decades. But Americans won’t stand for government financing with strings attached. No matter who pays the piper, Americans want patients to call the tune.
HT: Sparked by Bill Dickens’ Facebook feed.