The growth in Medicare costs continues to be slow, in what is perhaps the most encouraging fiscal development for the U.S. in decades. If the health-care system is to continue to provide better value for Americans, policy makers need to seize this moment. Sadly, they are instead largely sitting on the sidelines.
The sluggish activity at the Patient-Centered Outcomes Research Institute provides a vivid illustration. It is simply not possible to make health care more efficient without knowing how treatments stack up against one another. So-called comparative effectiveness research is needed to find out, for example, whether spinal fusion surgery works better than the alternatives in relieving back pain, or whether proton beam therapy is worth the extra cost to treat prostate cancer.
Although the National Institutes of Health and private companies conduct research on whether new drugs, devices and surgical interventions are safe and effective, they perform few if any assessments of whether a product is more effective than existing alternatives. Nor is the Food and Drug Administration required to evaluate that question. Yet what patients and doctors want to know is how well different approaches work in comparison to one another, not whether each is better than nothing.