post by Paul Kelleher
If an [Implantable Cardiac Defibrillator] were a buck and a quarter, would we have gone through this entire process of reviewing the evidence at all? Maybe not. But because it's a bit more than a buck and a quarter we wanted to make sure the evidence was clear and that it was a benefit. We don't use cost to decide the evidence issue, but we do use cost to decide if this is important enough to address.
That is Dr Steve Phurrough, then-acting director of the Centers for Medicare and Medicaid Services Coverage and Analysis Group, speaking in 2003. I find this quotation shocking, and I wonder if others do as well.
I have no idea if things at CMS have changed since 2003, but this strikes me as illustrating one reason why it can be good for health care to be pricey. I do not claim that this reason makes it true, all things considered, that health care is so expensive. But its just not clear that we would be better off if health care grew on trees.