Mr. Speaker, in the past few weeks there has been a concerted media campaign to spread misinformation about the Comparative Effectiveness Research (CER) provisions in H.R.1. To set the record straight, I submit for the Record the following…
Mr. Speaker, in the past few weeks there has been a concerted media campaign to spread misinformation about the Comparative Effectiveness Research (CER) provisions in H.R.1.
To set the record straight, I submit for the Record the following summary of the comparative effectiveness research provisions and a list of organizations that have written us in support.
This investment is an important first step in efforts to develop a robust CER program in this Congress. In the near future, I will introduce a comprehensive CER proposal, based on the provisions that previously passed the House in the CHAMP Act, H.R. 3162, in the 110th Congress.
American Recovery and Reinvestment Act of 2009 (ARRA)
Provisions on comparative Effectiveness Research
The conference agreement on H.R. 1 includes provisions to
promote and expand research that compares the effectiveness
of alternative treatments or strategies for a medical
condition.
Doctors today urgently need better evidence to improve the
quality of health care that patients receive. Some estimates
indicate that less than half of all therapies patients
receive are actually supported by firm evidence of
effectiveness.
There is widespread agreement on the need for better
information on the comparative effectiveness of different
interventions for health conditions. In an October 2008 joint
editorial, Newt Gingrich, John Kerry and Billy Beane said
that ``a health care system that is driven by robust
comparative clinical evidence will save lives and money.''
Some of the oldest and most important studies in medicine
have been comparative effectiveness studies. For example, the
Diabetes Control and Complications Trial revolutionized the
treatment of patients with type 1 diabetes. This landmark
trial found that aggressive use of insulin to control blood
sugar was clearly better than standard care in preventing
damage to the eyes, kidneys, and nerves of patients with
diabetes.
But more must be done. In December 2008, the Institute of
Medicine called for further comparative effectiveness
efforts, stating that ``this type of research would provide
information that patients and physicians need to make choices
that offer them the greatest value, as they define it.'' The
National Institutes of Health (NIH) and the Agency for
Healthcare Research and Quality (AHRQ) both have planned to
expand their research efforts, but these expansions have
proceeded slowly due to a lack of funding.
An investment in this research infrastructure will provide
doctors and patients with critically important information.
Arming physicians with the best available evidence about
treatment alternatives and their effects in different patient
populations will help doctors and patients make better
choices.
Summary of provisions
The conference agreement provides $1.1 billion for
comparative effectiveness research with $300 million to be
administered by AHRQ, $400 million to be administered by NIH,
and $400 million to be allocated at the discretion of the
Secretary of Health and Human Services. These funds are to be
used to accelerate the development and dissemination of
comparative effectiveness research. The agreement ensures
that the use of these research dollars will be consistent
with governmental policies relating to the inclusion of women
and minorities in research.
The conference agreement also establishes a Federal
Coordinating Council for Comparative Effectiveness Research.
The purpose of the Council is to reduce duplication and
coordinate these research activities within the federal
government. Because its purpose is the coordination of
federal research efforts, the Council is made up of
representatives of a variety of experts from within the
federal agencies. The conference agreement clearly states
that the Council cannot mandate coverage, reimbursement, or
other policies for any public or private payer.
Supporters for these provisions
Widespread Support for Provisions on Comparative
Effectiveness Research. Experts, physicians, legislators, and
advocates from across the political spectrum supported
provisions in the stimulus package for comparative
effectiveness research because this research is crucial.
``The current limited availability of valid data to
supplement the physician's clinical experience and
professional knowledge . . . makes it difficult to ensure
that an effective treatment choice is made.''--Letter to
Congress from the American College of Physicians, January 29,
2009
``Opponents--like some drug companies and medical device
makers--don't want this research. They fear it will cut the
profits they make on ineffective drugs and equipment. But
they won't tell you that this research could save your life
by giving your doctors better information so they can
prescribe the best treatments available to you.''--AARP CEO
Bill Novelli, February 10, 2009
``Independent, objective comparative effectiveness research
(CER) is urgently needed to improve health care quality and
patient outcomes by ensuring consumers always receive the
best care.''--Letter to Congress, signed by the Alliance for
Better Health Care, (a broad coalition of over 30
organizations representing consumers, employers, health care
providers, health plans, pharmacists, researchers, unions,
pharmaceutical benefit managers, and others), February 11,
2009
``We are concerned that some believe that comparative
effectiveness could lead to the rationing of health care.
This is simply not true. The bill would fund independent,
objective, comparative effectiveness research that would
greatly benefit providers and patients in making informed
health care decisions.''--Letter to Congress signed by AARP,
AFL-CIO, American College of Physicians, America's Health
Insurance Plans, Blue Cross Blue Shield Association, Families
USA, National Business Group on Health, National Partnership
for Women and Families and joined by Consumers Union,
February 12, 2009
``Strong federal support for comparative effectiveness
research is vital to both public and private efforts to
improve health care quality for patients and to give
physicians and other health care providers the independent,
objective information they need to identify the best
treatments options for their patients.''--Letter to Congress
from the National Business Group on Health, February 11,
2009.
Mr. Speaker, I rise in support of the Conference Report on H.R. 1, the ``American Recovery and Reinvestment Act of 2009.''
The economic challenges we are confronted with are as serious as any we've faced since the Great Depression. There is no doubt that we are paying the price for eight years of unregulated markets, regressive tax breaks, and a lack of investment in the needs of the American people. Now is the time to act boldly to create jobs, strengthen the frayed safety net, begin to fix our health care system, and make long-overdue investments in education, scientific innovation, and infrastructure that will spur our economy forward in the years to come. This legislation achieves all of these goals.
As Chairman of the Ways and Means Health Subcommittee, I am most proud of the health provisions in this legislation.
It is no overstatement to say that the development of an interoperable health information technology system in America will revolutionize medicine. H.R. 1 does just that. In addition to increasing efficiency and reducing unnecessary spending in our medical system, electronic health records will enable doctors to have the information they need--at their fingertips--to best treat their patients.
By building financial incentives into Medicare and Medicaid, and developing new grant programs, the Congressional Budget Office estimates that this bill will encourage 90 percent of physicians in America to adopt standardized health IT and that 70 percent of America's hospitals will do the same. They also calculate that the improvements from this legislation will generate more than $12 billion in savings from federal health programs and reduce health insurance premiums in the private sector as well.
H.R. 1 also makes a substantial investment to expand comparative effectiveness research. Right now, patients with the same diagnosis often receive dramatically different treatment. Medicine is an art, but also must be guided by science. By investing in this research, doctors and other health care providers will be able to obtain unbiased information regarding which procedures, pharmaceuticals, devices and other treatments work best for particular conditions. That way, they can choose the right treatment from options that have been independently evaluated.
If you've heard any controversy about this provision, it's because the pharmaceutical and medical device industries are spending millions of dollars to drum up opposition. They don't want doctors or patients to be able to objectively evaluate the value of their products. The smear campaign of disinformation has also been advanced by conservative ideologues in a cynical effort to foment distrust and discord prior to beginning a national conversation on health care reform. In fact, this research is broadly supported by a wide range of groups representing patients, physicians, health care organizations, unions and others.
H.R. 1 also protects the health care coverage for millions of workers who are losing their jobs because of our economic crisis. COBRA health continuation coverage provides a vital bridge for people to maintain their health benefits when they are between jobs. However, an average family COBRA premium is more than $1000 a month--a financial commitment most unemployed workers can't afford on top of their mortgages and other costs of daily living. By providing a 65 percent subsidy for these premiums for up to 9 months, H.R. 1 will help more than seven million people maintain their health coverage while they seek new employment.
When H.R. 1 is signed into law, the 111th Congress and President Obama will have done more to advance health care in America in less than two months, than was done over the entire two terms of the Bush Administration. We will also have set forth a solid road to move into the debate to guarantee that each and every person in America has affordable, quality health care that can't be taken away.
In addition to the vital health care provisions, H.R. 1 includes essential provisions that will stimulate our economy in the short-term and build a foundation for long-term prosperity. By funding ``shovel- ready'' road, rail, water, school, and energy infrastructure projects we will create millions of new jobs, including more than 7,500 in my district. By bolstering safety net programs such as Unemployment Insurance and Food Stamps we are giving assistance to those hardest hit by the downturn. By investing in all levels of education, science, and clean energy we are setting the stage for economic renewal and the innovation that will drive our economy.
As President Obama has said, we will not get out of this economic mess overnight. But we can take the bold action that the current crisis demands and start the process of rebuilding our economy by passing the legislation before us today.