Year: 2013
Type: article
Abstract: A regrettable feature of the debate leading up to the adoption of the Patient Protection and Affordable Care Act (ACA) in 2010 was the controversy over whether the new law would lead to inappropriate "rationing" of cancer screening and treatment.In particular, opponents of the law pointed to a recommendation from the U.S. Preventive Services Task Force (USPSTF) [1]-that had nothing to do with the ACA or the comparative effectiveness research it now funds-as an example of how the new law would limit access to care and undermine the quality of the health care system by placing cost control ahead of quality.Not only did these attacks have little merit, they distracted attention from the more likely effect of the ACA on cancer screening and treatment.By extending public and private health insurance to approximately 30 million Americans and prohibiting a number of health insurance practices that limit coverage, the ACA has the potential to reduce ethically troubling disparities in access.Is "Comparative Effectiveness Research" Really a Threat to Cancer Care?The controversy over the USPSTF's recommendation against routine mammography screening among women ages 40 to 49 without other risk factors for breast cancer was caught up in a large debate about the role of comparative effectiveness research (CER).This debate reached a fever pitch during the health reform deliberations of 2009-2010.CER is the effort to compare the effectiveness of competing health care technologies and advocates hope it will generate evidence that can be used to improve the quality and efficiency of the health care system [2].The Obama administration signalled its enthusiasm for this research when it invested $1.1 billion in CER as part of the American Recovery and Reinvestment Act (ARRA) in 2008.The ACA expanded this investment and created the Patient-Centered Outcomes Research Institute (PCORI) to direct federal CER efforts.
Source: The AMA Journal of Ethic
Author: Michael K. Gusmano
Institution: Hastings Center
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W25326660