Trust Me, This Won't Hurt A Bit

  • by: |
  • 02/05/2008
Here's another great example of comparative effectiveness translated into clinical practice.....This from AP..

"A group of doctors from New Jersey is opposing a plan by Aetna Inc. to drop coverage of a type of anesthesia used during colonoscopies.

Gastroenterologists and other doctors say patients anxious about colorectal screening may balk unless they are assured that their insurance coverage includes the cost of anesthesiologists who administer propofol, an anesthesia the doctors say is effective and comfortable.

"The idea should be to encourage these procedures because of their lifesaving ramifications," said John Fanburg, counsel for the New Jersey State Society of Anesthesiologists and the New Jersey Gastroenterology and Endoscopy Society...

As of April 1, the Hartford-based insurer plans to continue to routinely cover moderate sedation, but limit coverage of so-called monitored anesthesia care by an anesthesiologist to patients who are at higher risk due to illness or other complications.

"Propofol works faster, but whether it results in improved patient satisfaction is difficult to prove," said Robert McDonough, head of Aetna's clinical policy unit.

Translation: We will let you know when there is enough data and what is the definition of improved patient satisfaction. Aetna is telling patients that for $200 they can suffer and worry through their surgery and exam. By the way, if it's difficult to prove, why is the burden of proof on the patient, not Aetna, especially since it's our money?

That my friends is a great metaphor for evidence-based medicine. It's your money and your tuchus but someone else is telling you how the procedure is going to be done because it might save money though in the words of McDonough, whether it does "is difficult to prove."

But for the comparative effectiveness crowd, who see patients as mere cost centers, there is no complaining. Just bend over and take it.

Anti-intellectual freedom. Anti-consumer choice. Is achieving a pharma free, single payer system really worth all this loss of freedom?

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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