The Knowledge Cure

Michael Kinsley wants better health care data:

Hillary Clinton's health-care plan 16 years ago included a provision for collecting outcomes data. Opponents misrepresented this as a massive invasion of your privacy, and it helped to kill that effort. Another charge about keeping outcomes data is that it will lead to rationing. People will be told they can't have the pill or the surgery they want because it is too expensive and outcomes data show that it doesn't work. Or it works no better than some other therapy that is cheaper. I suspect that this latter concern is realistic.

But the notion that it can be avoided is not. Telling people they can't have treatments that are proven wastes of money isn't rationing. It's sanity. And refusing to find out what doesn't work, for fear that we will be told we cannot have it, is doubly nuts.

The problem will arise when an expensive therapy turns out to be, not worthless, but just a tiny bit better than a cheaper alternative. At that point some agonizing decisions will have to be made. But isn't it better to make them with knowledge than in ignorance?

Virginia Postrel wrote about whether national health care will put expensive drugs out of reach a few months ago. My concern is that we be honest about the real trade-offs here. Increasing the government's leverage on drug companies to restrain soaring drug costs may well be worth the loss of research and development that has done so much to transform American medicine these past couple of decades. But there will be a loss. This trade-off between innovation and access is real (and I would lean on the side of innovation). But at least Kinsley wants reliable data on which to make the hard decisions.I see no reason not.