Saturday, February 4, 2012

Worse Than Death Panels

Remember these words: "evidence-based care." They are likely to be very much a part of your future. IF you are elderly or disabled, odds are that Medicare will eventually refuse to pay for any procedures that aren’t evidence-based. If you get health insurance at work, your employer will probably do the same. If you buy your own insurance, you won’t have much choice about the matter. The only health insurers that will be allowed in the new (ObamaCare) health insurance exchanges — certainly the only ones that survive — will be those that limit coverage to evidence-based care.

So what’s wrong with evidence-based medicine? Wouldn’t you want your doctor to make decisions based on scientifically verified evidence?

Most of what doctors do is what they and their colleagues have found to work. A study by the Institute of Medicine, for example, concludes that "the evidence base on the effectiveness of most health services is sparse."
In another Institute of Medicine study, researchers found that fewer than 20% of the American Heart Association/American College of Cardiology heart disease management recommendations "are based on a high level of evidence." If doctors were forced to do only those things that are evidenced-based, patients would be deprived of most of what doctors do.

Second, even where there are well established guidelines, they are inevitably written for the average patient. But suppose you are not average. Is your doctor free to step outside the protocols and give you care based on her training, knowledge and experience? Or will she be pressured to stick to the cookbook, regardless of how the patient fares?

"third" was not copied... it stated a statistic without evidence or verifyable link...

Fourth, evidence-based guidelines are based on studies; and these studies often exclude entire segments of the population. For example, a large number of studies of patients with heart failure excluded elderly patients, even though most of the people who have this problem are elderly!

Finally, the whole idea behind guidelines and protocols is that it is appropriate to treat patients with similar conditions the same way. But individuals are individuals. They don’t always respond to treatments the same way. For substance abuse, for example, there apparently is no such thing as a protocol that works for diverse groups of patients.

Worse Than Death Panels - John C. Goodman - 02/04/2012- Townhall Conservative

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