As liberal Democrats clamor to achieve the hopes of eight lost yearswith a new administration, many Americans simply look for jobs,economic security and lower health care costs. Their desire for changefalls far short of the current direction charted by House Democraticleadership. Health care debates of the 111th Congress will highlightstark differences between liberal wings of the Democratic Party andAmericans who seek to maintain their choice of doctors and have accessto the most effective prescriptions and procedures.

During the current economic stimulus dispute, House Democrats’objections to a Senate agreement that taxpayers should fund research onclinical effectiveness, rather than cost effectiveness, led to harshwords between House Appropriations Chairman David Obey (D-Wis.) andseveral Senatorial colleagues. Senators made this change knowing publicand private health plans might use cost data as a reason to deprivepatients of needed treatments, leading to a fight.

Congress must decide whose interests we serve — patients and doctorswho need better information on clinical effectiveness or third-partypayers whose primary concern is cost.

Simply put by House Minority Leader John Boehner (R-Ohio) on Tuesday,“we won’t create or save jobs by having the government rationAmericans’ health care options. These decisions should be made bypatients and doctors, not by government bureaucrats.”

The House Rules Committee rejected an amendment that I introduced toprevent Medicare officials from using cost-effectiveness research todeny coverage for treatments that would benefit patients. The Senateproposal modifies the House language but leaves an opening for patientsand doctors to be denied treatment options. Proponents of asingle-payer government system will try again to deny life-savingoptions best left to the doctor and patient, not governmentbureaucrats.

What works best on average is not always best for each individualpatient. This can be a critical problem for women, children,minorities, senior citizens and patients with multiple chronicconditions. Comparative effectiveness research and cost-effectivenessanalysis do not typically consider differences in patient responses totreatment options.

Researchers create arbitrary formulas that place a lower value on thelives of elderly and disabled patients, while disregarding the uniqueneeds of minority groups. The Congressional Black Caucus raised thissame concern in a 2008 letter to Ways and Means Chairman Charlie Rangel(D-N.Y.). They said federal research should not be “used as rationalefor limiting care to what works on average, rather than what works bestfor each, individual patient.” Now, the CBC and moderate Democraticgroups — including the Blue Dog and the New Democrat coalitions — areattempting to step away from this drastic policy change that they firstsupported.

Unfortunately, House leaders disregarded these warnings. Obey gave agreen light to rationing needed care by stating in report language thatmedical treatments that are “more expensive will no longer beprescribed.”

We must reduce costs and improve quality without allowing Medicarebureaucrats to deprive patients of “reasonable and necessary” care.Patients will suffer if cost becomes the primary factor in determiningMedicare coverage decisions. Reporting on a similar issue, New YorkTimes journalist Robert Pear explained: “Some services, like kidneydialysis, have contributed to the increasing cost of Medicare but savedthousands of lives.”

It’s time for House Democrats to set their priorities straight.Congress should fund research to improve the quality of patients’medical care, instead of creating new barriers to deprive them ofbeneficial treatments.

Rep. Charles Boustany (R-La.) is the ranking member of the Ways and Means Subcommittee on Oversight.

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