Business Owners Must Chip In for Obamacare's 'Comparative Effectiveness Research'

Susan Jones | May 1, 2013 | 10:07am EDT
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President Barack Obama signs the Affordable Care Act on March 23, 2010. (AP Photo/Charles Dharapak, File)

( - Business owners voiced a number of complaints about Obamacare Tuesday at a congressional field hearing in Concord, N.C.

Costs are one issue, the critics said, and uncertainty is another: "One of the issues is also that we keep learning things," said Chuck Horne, the president of a family-owned textile business that employs 350 people and got its start in 1946.

"Just yesterday, I learned we will pay two dollars per covered individual to pay for the Patient-Centered Outcome(s) Research Institute, whatever that is. And we just keep learning these things as time goes by."

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The Patient-Centered Outcomes Research Institute -- PCORI for short -- is one of the many controversial aspects of Obamacare. Its focus is "comparative effectiveness research" -- a best-practices database, which compares different treatments for a variety of ailments to decide which one works best for the most people.

The Patient-Centered Outcomes Research Institute says it is authorized by Congress to conduct research to help patients and their doctors make better-informed decisions: "PCORI’s research is intended to give patients a better understanding of the prevention, treatment and care options available, and the science that supports those options."

Critics say government bureaucrats, based on the research PCORI accumulates, will decide which treatments Obamacare will pay for and which ones it won't, making Obamacare a one-size-fits all health care system.

"Their decisions will be based upon Comparative Effectiveness Research, which uses population studies to draw conclusions about best practices in medicine," one physician told a congressional committee last year.

Those conclusions will be "suspect," Dr. Richard Armstrong said.

"Their purpose is simply to cut costs by reducing reimbursement to providers until 2020, when they can begin to target hospitals. The effect on physicians' ability to make medically accurate choices for their individually unique patients is likely to be sharply curtailed, Armstrong told the House Oversight and Government Reform Committee in July 2012. Armstrong is the chief operating officer of Docs4PatientCare, a group of physicians opposed to Obamacare.

While critics denounce comparative effectiveness research as "rationing," one Democrat has praised it as "smart rationing."

At a congressional hearing on Feb. 26, 2013, Rep. Ron Kind (D-Wis.) said comparative effectiveness research will drive people to "high-value care" and away from "less-value care."

"We need smart rationing within the health care system because you don't want to be spending money on stuff that doesn't work, or leave patients even worse off than when they go in," Kind told a House Ways and Means subcommittee on Feb. 26, 2013.

Like it or not, comparative effectiveness research is moving full speed ahead as the taxpayer-funding spigot opens.

Last week, PCORI announced it has up to $68 million to spend on the development of a national clinical research network. Such a "data-rich infrastructure" -- which depends largely on electronic health records and patient self-reporting -- will "benefit all Americans," said PCORI Executive Director Joe Selby.

Here's how the funding (Phase I) breaks down for the new research network:

PCORI says up to $56 million is available to support up to eight new or existing Clinical Data Research Networks. These CDRNs will compare various patient treatments and outcomes, in part by tapping electronic health data from multiple hospitals, clinics or other medical centers.

Another $12 million will flow to 18 new or existing Patient-Powered Research Networks. PPRNs are groups of patients with the same medical condition who are "motivated" to take part in research that will help others with the same ailment.

"This group is ready and willing to engage with researchers and participate in prospective studies to better understand their condition," the funding announcement says. A protected online portal will collect any data these patients report about themselves, and it will allow them to see the information entered by other (unidentified) patients. The goal is to have these PPRNs grow larger and larger -- and "become more representative of all patients with the condition."

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