Plot To Destroy Healthcare? Not!

It's true: they did it. The Democrats managed to get the words "comparative effectiveness" into the stimulus bill, just as many conservatives warned, which means that the infrastructure for rationing Medicare is now in place. The idea is pretty simple: a national health board will determine the comparative effectiveness of different treatments for different ailments, and then... well... you know, recommend them, in that coercive way that government does.

In Tom Daschle's book, he contemplated, in a footnote, the idea of using such a national health board to regulate private health care plans, by threatening to take away the tax deduction for plans that don't use the correct comparative effectiveness treatments. So, yes, the government will pretty much be running the health care system at that point. Well, it will be to a greater extent than it already is.

And yet, and yet, and yet... I'll say it. Comparative effectiveness is good. Controlling the spiraling-out-of-control, eat-us-alive costs of Medicare is good. I'll even go so far as to say that greater limits on the tax deduction for health benefits are good, good, good.

And I'm not sure why I should say otherwise, as a conservative.

I seem to recall a bill, passed in 2001, called "No Child Left Behind". One of the main parts of that bill, the part that just about every conservative actually liked, was the part where they tied new grants to literacy programs that used, yes, comparative effectiveness research. The main program that benefited from that requirement was Direct Instruction, which was and is so effective that skeptical teachers tend to think that the whole comparative effectiveness idea -- really, any form of accountability tied to method -- is a total sham cooked up by The Man. No, they'd rather stick to the tried-and-true method of continually trying out the next (expensive) educational panacea promoted by the (well-compensated) textbook reps at the big conventions (at nice hotels), and buying all new (expensive) books and all new methods (that require expensive retraining seminars, possibly at that same hotel next quarter) every five years or so, all of which is based on research paid for, of course, by the textbook reps.

Good thing our free-market health care system isn't anything like that. What a waste that would be.

I exaggerate for rhetorical effect, of course; it's my right. But there isn't a more conservative sentiment than "that's all well and good, but not on my dime." So, why don't we make the argument; or rather, why does one side make the argument in one case, and the other side make the argument in the other?

Well, teachers and publishers are a Democratic constituency, and doctors and Pharma reps are a Republican constituency, by and large. That may have something to do with it.

It makes you wonder.

(Thanks to John Hawkins for the inspiration.)