Ezra Klein with the short version:
the short version is that you use evidence to change, rather than decide, reimbursement rates. Statins, for instance, are very effective and we want them to be widely used. So cover that at 100 percent. No out of pocket payment at all. Lumbar surgeries, conversely, are very ineffective, and the evidence suggests that fewer should be used. So cover them at 30 percent. You're not barring anyone from accessing the care they want. It's hard to say you're rationing. But you're setting the system's incentives to prioritize the care that works, and is cost effective.
Be sure to read Dr. Grace Jackson's "Open Letter to the Federal Coordinating Council for Comparative Effectiveness Research" posted at the Institute for Nearly Genuine Research web site:
ReplyDeletewww.bonkersinstitute.org/jacksonletter.html