Hefty Health Spending in Stimulus Bill
Law Signed by President Obama Includes Funds for Medicare, Research, and Insurance
The bill includes $10 billion to increase the research budget of the
National Institutes of Health (NIH).The Senate originally boosted that spending
by $6.5 billion, but the figure was moved higher in negotiations with the
House. That's on top of the agency's $29 billion budget, which remained flat
Medical and research groups praised the extra funding. "This bill will
reverse years of flat research funding, create economic growth, and allow
doctors and researchers to accelerate progress against cancer and other
diseases," Richard L. Schilsky, MD, president of the American Society of
Clinical Oncologists, says in a statement.
Many policy experts are calling for more studies pitting different drugs,
treatments, or care regimens directly against each other. The hope is that the
studies will tell policy makers, doctors, and insurance companies which
treatments actually work best and which are the most cost-effective.
Both parties have called for the research, and the bill devotes $1.1 billion
to comparative-effectiveness studies at NIH and other agencies.
James Weinstein, MD, a comparative-effectiveness researcher at the Dartmouth
Institute for Health Policy and Clinical Practice, says the health system is
full of examples of more expensive treatments that may not necessarily be
better. One example is thiazide diuretics, which research suggests are just as
effective as more expensive calcium channel blockers at lowering blood
pressure, preventing heart attacks, and avoiding hospitalizations.
"And if the drug was the same, shouldn't the nation think about using
the drug that's just as good for a third the price?" he tells WebMD.
The inclusion of the money in the stimulus package angered some Republicans,
who argued that the new law opens the door for government or private insurers
to refuse payment for certain kinds of care based on the studies. That could
lead to rationing of medical care if the government takes a bigger role in
national health policy as part of reform efforts.
Billions of dollars could be at stake if one drug or treatment is found to
be more cost-effective than another, Aaron says. He called the studies
potential "political dynamite."