But as the program swings into full gear, it is becoming apparent those promises can't be kept -- at least not without major intrusion into health care decisions that affect patients. One of the only ways to save money is to restrict access to more costly treatments, which is exactly what the Patient-Centered Outcomes Research Institute (PCORI), a public-private organization set up by the Affordable Care Act, is meant to do. The PCORI recommends lower reimbursement for drugs and treatments that ostensibly are not research-based.
Unfortunately, even the new rules don't deliver as anticipated. Instead of basing health care decisions on evidence-based research, the government is pushing providers to cut costlier treatments, even if there isn't a good empirically researched reason for doing so. And the results could end up costing more money as patients denied certain treatments become sicker and harder to serve.
A group of patients whose lives may be endangered by this shift are among the most vulnerable: premature babies. Babies born before 37 weeks of pregnancy are at increased risk for many health complications, and among the most dangerous are respiratory diseases. These tiny babies' lungs are more susceptible to serious infections from common childhood diseases like RSV (respiratory syncytial virus), and the consequences from infection can be much more dangerous.
RSV is one of the most common infections to afflict young children. In most healthy, full-term babies and toddlers, the infection may create discomfort, mild fever and cough, but the symptoms disappear after a few days. But for babies and young children with impaired immune systems or immature lungs, the virus can lead to pneumonia and bronchiolitis, which cases airwaves to fill with mucus and makes it difficult for the baby to breathe. Each year RSV sends about 400,000 children to emergency rooms, while 125,000 children end up hospitalized and 500 die.
Despite this, the American Academy of Pediatrics has adopted new recommendations on RSV prevention for preemies that seem more focused on cost cutting than good patient care.
Linda Chavez is chairman of the Center for Equal Opportunity and author of Betrayal: How Union Bosses Shake Down Their Members and Corrupt American Politics .
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