How Comparative Effectiveness Works in Medicare
This is from an editorial in the New York Times:
Medicare has proposed not to pay for so-called virtual colonoscopies because there is not enough evidence that they would benefit people aged 65 and older. That may be disappointing for older Americans who would prefer a virtual exam to a real one. But those sort of judgments will be fundamental to any successful health care reform effort.
Lest I mislead, I'm not against Medicare making these decisions. As a taxpayer, I have a self interest in not seeing money wasted. What I'm against is a monopoly health insurer, which gives patients and doctors no alternatives.
Exactly the right point. If the government is making the decisions on what is cost effective, the inevitable pressure will be not to cover things.
If private insurers competing with each other make these decisions, they will have to meet the market test.
I agree with Tom.
In England, where cost control is a little further along, the NHS offers a faecal occult bowel screening test kit every other year to people between 60 and 69. If you flunk you do the test two more times. Then you get referred for a colonoscopy. If you are over 70 years old, you have to ask for a kit.