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Thursday, October 29, 2009

Government run comparative effectiveness panel and regulatory capture - Fait Accompli?

Is the deck already stacked for a regulatory capture type scenario in regard to the government version of comparative effectiveness research panel? At least according to one bill it is. Read Dr. Roy Poses's account of what is in store and what sorts of folks will constitute the panel.

After noting that in the draft bill ( I don't know if there are provisions in other draft bills on not) that 6/25 of panel members will represent for-profit organizations , Dr. Poses continues:

We often discuss how clinical research sponsored by organizations with vested interest in the research turning out to favor their products or services may be manipulated to favor these interests, and sometimes suppressed if it does not. In the US, there are few unconflicted sources of sparse funds to support comparative effectiveness research.

...If the government is going to support comparative effectiveness research, it ought to make sure such research is not run by people with vested interests in the outcomes coming out a certain way.

"Making sure" that a government endeavor is not run or significantly influenced by interest groups may be not possible considering the strong, well practiced, very well funded lobbying capabilities of vested interests (Madison spoke of factions and hoped in vain that a republic versus a direct democracy would hold them at bay)) and the general inability ( or lack of desire) on the part of legislators to resist their efforts.

The composition of the CER panel is regulatory capture preemption at its best-writing into the bill a seat at the planning table for representatives of vested interests. Go to Dr. Poses commentary for details of the appointment and composition of the panel. Note this panel is not a government agency but it is appointed by government and its work product will greatly influence health care funding and ultimately decisions made by physicians and insurance companies.

"If the government is to tell big business men how to run their business, then don't you see that big business men have to get closer to the government even than they are now? Don't you see that they must capture the government, in order not to be restrained too much by it? Must capture the government? They have already captured it.".....Woodrow Wilson,1913

I welcome comments from those who expressed optimism and enthusiasm for government sponsored CER now that some of the details of how that will work are becoming available.

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