HEALTH REFORM: How "Evidence-Based Baseball" Can Help Us Fix Health Care

None of us need to be reminded that we live in a time when every dollar, including every health care dollar, has to count. We highly recommend a terrific New York Times op-ed today by the unlikely trio of Sen. John Kerry, former House Speaker Newt Gingrich and Oakland A's General Manager Billy Beane. They call for government-backed, truly independent comparative effectiveness program to find out what works in medicine and what we should stop wasting our money on. And remember, they penned this piece even before this week's headlines about the widespread practice of doctors prescribing placebos.

Wonder why the Oakland A's are relevant? Read the piece to capture the whole lovely argument but the gist is that baseball has experienced what the authors call a "data-driven information revolution. Number crunchers now routinely use statistics to put better teams on the field for less money." We've learned from the Dartmouth Atlas and numerous other researches that more isn't always better in health care, that lower-cost hospitals get as good or better results than the bigger spenders. Well, the Tampa Bay Rays (and we know how it must have hurt Boston-based Sen. Kerry to write these lines) have the second-lowest payroll in baseball. Yet they are the ones in the series while the bigger bucks teams are watching it on TV. Here are a few highlights from the peice:

Remarkably, a doctor today can get more data on the starting third baseman on his fantasy baseball team than on the effectiveness of life-and-death medical procedures....

Evidence-based health care would not strip doctors of their decision-making authority nor replace their expertise. Instead, data and evidence should complement a lifetime of experience, so that doctors can deliver the best quality care at the lowest possible cost.

Working closely with doctors, the federal government and the private sector should create a new institute for evidence-based medicine. This institute would conduct new studies and systematically review the existing medical literature to help inform our nation's over-stretched medical providers. The government should also increase Medicare reimbursements and some liability protections for doctors who follow the recommended clinical best practices.

They pack a lot in here, including a potential bipartisan fix to the long-running fight in Congress about malpractice reform. We've strongly backed comparative effectiveness before, it's got growing (though admittedly not universal) bipartisan support in Congress. Obama and McCain both endorse the concept. Let's hope the current economic crisis makes this a top priority for Congress next year, even if certain sectors in the health care industry don't like it. As the authors conclude, "The best way to start improving quality and lowering costs is to study the stats." We won't go quite so far as to suggest that we should scrap complex quality reports that people don't understand and replace them with "doc trading cards" with cost, complication and mortality rates instead of RBIs, hits and errors. But you get the idea.

(Gooznews also has feisty post on this topic today.)