Rep. Charles W. Boustany, Jr., MD
Submitted exclusively to Politico

As liberal Democrats clamor to achieve the hopes of eight lost years with a new Administration, many Americans simply look for jobs, economic security and lower healthcare costs.  Their desire for change falls far short of the current direction charted by House Democratic leadership. Healthcare debates of the 111th Congress will highlight stark differences between liberal wings of the Democratic Party and Americans who seek to maintain their choice of doctors and have access to the most effective prescriptions and procedures.

During the current economic stimulus dispute, House Democrats’ objections to a Senate agreement that taxpayers should fund research on clinical effectiveness, rather than cost effectiveness, led to harsh words between House Appropriations Chairman Obey and several Senatorial colleagues.  Senators made this change knowing public and private health plans might use cost data as a reason to deprive patients of needed treatments, leading to a conference fight.

Congress must decide whose interests we serve – patients and doctors who need better information on clinical effectiveness or third party payers whose primary concern is cost. 

Simply put by House Republican Leader John Boehner on Tuesday, “…we won’t create or save jobs by having the government ration Americans’ health care options.  These decisions should be made by patients and doctors, not by government bureaucrats.”

The House Rules Committee rejected an amendment I introduced to prevent Medicare officials from using cost-effectiveness research to deny coverage for treatments that would benefit patients.  The Senate proposal modifies the House language but leaves an opening for patients and doctors to be denied treatment options.  Proponents of a single-payer government system will try again to deny life saving options best left to the doctor and patient, not government bureaucrats.
 
What works best on average is not always best for each individual patient.  This can be a critical problem for women, children, minorities, senior citizens, and patients with multiple chronic conditions.  Comparative effectiveness research and cost-effectiveness analysis do not typically consider differences in patient responses to treatment options.

Researchers create arbitrary formulas that place a lower value on the lives of elderly and disabled patients, while disregarding the unique needs of minority groups.  The Congressional Black Caucus raised this same concern in a 2008 letter to Chairman Rangel.  They said federal research should not be “used as rationale for limiting care to what works on average, rather than what works best for each, individual patient.”  Now, the CBC and moderate Democratic groups – including Blue Dogs and the New Democrats – are attempting to step away from this drastic policy change they first supported.
 
Unfortunately, House leaders disregarded these warnings.  Chairman Obey gave a green light to rationing needed care by stating in report language that medical treatments that are “more expensive, will no longer be prescribed."

We must reduce costs and improve quality without allowing Medicare bureaucrats to deprive patients of “reasonable and necessary” care.  Patients will suffer if cost becomes the primary factor in determining Medicare coverage decisions.  Reporting on a similar issue, New York Times journalist Robert Pear explained: “Some services, like kidney dialysis, have contributed to the increasing cost of Medicare but saved thousands of lives.”

It’s time for House Democrats to set their priorities straight.  Congress should fund research to improve the quality of patients’ medical care, instead of creating new barriers to deprive them of beneficial treatments.