The connection between Kitzhaber and Gregoire on evidence-based medicine was confirmed recently in a hearing before the House Appropriations Committee. John Kitzhaber is former governor of Oregon who is mounting a full-scale promotion of organized, sane health care. Chris Gregoire is the new Washington governor bent on making changes that make sense.
The podcast link to that hearing is here. The Appropriations Committee does it in other media too. It's great stuff. It is also leadership, figuring out where we need to go and setting about getting there.
I guess I'm behind the curve on this. I didn't realize drugs weren't measured against each other to gauge effectiveness. They're measured against a placebo. Part of evidence-based medicine ("evidence of effectiveness and benefit") is setting up comparisons between drugs and drugs or drugs and other procedures.
Surgical procedures are analyzed for effectiveness. The gastric bypass, for example, was determined to be effective, but only for the morbidly obese.
Providers are judged, too. If one clinic has a significantly higher success rate than another, why are we not funneling state business to that clinic?
What makes most sense is having independent analysts examine the material, the studies. People without a horse in the race judging providers, discounting biased trials and phony findings. They're doing this at the Oregon Health and Sciences University. John Santa from that school's Center for Evidence Based Policy was there to testify.
While Kitzhaber has said, "It's too late for incremental change," a good first step is getting state capacity in this area. State Health Care Authority administrator Steve Hill estimated 25 to 30 percent of the $4 billion spent on health care annually is wasted (compare to $350 million per year total budget for projects under the 9-cent gas tax). Only a fraction of this waste is in administration, the rest is "overuse, under use, and misuse in health care treatment."
Administrative savings in the health care field can be found aplenty, too. But don't look at government programs. That address is Private Corporate Health Care Insurance Company, Inc. For a good look at the enormous waste of private sector providers, see the folks at Health Care for All - Washington