by Patrick Appel

After lambasting "Evidence Based Medicine," Abraham Verghese responds to his critics and points to this article from the Annals of Internal Medicine on Obama's heathcare savings proposals. From the conclusion:

 Claims of savings from health information technology, prevention, [Pay For Performance], and comparative effectiveness research are politically attractive. Their political appeal lies largely in the embrace of widely supported goals, including better health and improved quality of medical care. In theory, these reformsmore research, more preventive screenings, and better organized patient datasound like benign devices to moderate medical spending. For many purposes, such reforms are substantively very desirable. But these reforms are ineffective as cost-control measures.


If the United States is to control health care costs, it will have to follow the lead of other industrialized nations and embrace price restraint, spending targets, and insurance regulation. Such credible cost controls are, in the language of politics, a tough sell because they threaten the medical industry's income. The illusion of painless savings, however, confuses our national debate on health reform and makes the acceptance of cost control's realities all the more difficult.

On a related note, Jonathan Cohn has an exclusive on the Congressional Budget Office's preliminary healthcare estimates:

Bottom line: If you're a wonk like me, trying to figure out how much money it will cost to get reform done right, it's safe to assume the number will be north of $1 trillion, but perhaps not as far north as a lot of people thought, albeit with a modest group of people still uninsured.

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