Word: limitates
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...medicine, joined by a variety of patient groups (some of whom also receive industry funding) concerned about access to care. Coelho says he welcomes effectiveness research if it can help doctors and patients make more informed decisions, but he argues with passion that it should never be used to limit treatments, modify reimbursements or otherwise cut costs. "If you come at this trying to save the almighty dollar because you think we're spending too much money on drugs and devices and Sally and Joe, the American people will revolt," Coelho says. "You'll get your jollies because...
...agency to oversee the effectiveness research, so that decisions about what to study are separate from decisions about what to reimburse. And some of Obama's quality incentives are fairly straightforward, like extra dollars for primary care, prevention and computerization; to discourage wasteful defensive medicine, he seems willing to limit malpractice lawsuits when doctors stick to best practices. But ultimately, rewarding quality rather than quantity will require daunting changes in Medicare reimbursement policies. That could mean lower patient costs and higher provider revenues for proven treatments, but when patients want more expensive options unsupported by data, they may have...
...anything that's going to gore anybody's ox," Shalala says. "If Congress is going to be involved in the nitty-gritty payment details, reform is dead." Obama wants to let another independent agency, similar to the military-base-closing commission, recommend how to pay for quality, which would limit political haggling. But even if such a panel focused on clinical effectiveness rather than cost-effectiveness - so that taxpayers would cover vastly more expensive approaches as long as they were slightly more effective - the shift would still be dramatic for Medicare, which currently covers just about any possibly effective treatment...
...country to carry website-blocking software--a policy that gives the government even broader control over citizens' Internet access. Officials billed the move as a crackdown on pornography, but China's history of Web censorship has activists and Internet users concerned that the preinstalled software will be used to limit free speech and privacy...
...proposed by Mosley would be voluntary, but far more extensive technical restrictions would be placed on teams that decline to sign up, making it harder for them to stay competitive. Some of the top teams currently spend three or four times Mosley's proposed limit on R&D in search of that evolutionary advantage. (See pictures of the history of Formula...