How Washington Rations is a good article about the complexities politics will run into as politicians try to craft rules for all situations:
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This is precisely the sort of complexity that the Democrats would prefer to ignore as they try to restructure health care. Led by budget chief Peter Orszag, the White House believes that comparative effectiveness research, which examines clinical evidence to determine what "works best," will let them cut wasteful or ineffective treatments and thus contain health spending.
The problem is that what "works best" isn't the same for everyone. While not painless or risk free, virtual colonoscopy might be better for some patients -- especially among seniors who are infirm or because the presence of other diseases puts them at risk for complications. Ideally doctors would decide with their patients. But Medicare instead made the hard-and-fast choice that it was cheaper to cut it off for all beneficiaries. If some patients are worse off, well, too bad.
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Choices in life tend to go across a spectrum. What is best for young people may not be best for older people. Unfortunately politics often degenerates options to a single choice. Officials will decide one course of action for everyone, which may too often is not good for everyone.
By deciding on one course of action, it will be harder for new technologies to cross the chasm and become the better choice, down the road.
(Hat tip: Dr. Helen)
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Technorati tags: politics, choice
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