Health care issues: What's the best treatment?

AP News
Posted: Nov 17, 2009 4:06 PM

A look at key issues in the health care debate:

THE ISSUE: Researching which treatments work best and how much they cost, and how doctors and patients should use that information.

THE POLITICS: On the surface, it seems like common sense: How different health conditions are treated _ whether with surgery, drugs or managing diet and exercise, for example _ should depend on what works best and costs least. But how that information is used has become a hot-button issue in the current debate. Republicans argue that Democrats, the majority in Congress, want to prescribe which procedures are paid for and which are not, a form of rationing. They say government bureaucrats will intervene in what should be a decision between doctors and their patients. Democrats counter that they have no such intent, and seek only to provide the best information so that doctors and patients can voluntarily make better-informed decisions.

WHAT IT MEANS: Health care legislation working its way through Congress would provide new federal money for what's called "comparative effectiveness" research. The bills don't say how such information should be used; the House version, in fact, says specifically that cost effectiveness judgments can't be used to deny or ration care, though Republicans contend the language isn't strong enough. Supporters of the additional research say they hope the findings will be used voluntarily. Studies show that effectiveness research could help lower health care costs in the long run. Often, doctors and patients choose expensive new therapies without knowing whether they work any better than more traditional, lower-cost approaches.

_ Jim Drinkard