As health costs in the U.S. soar past $1.5 trillion, much evidence indicates that the nation does not get good value for its money. It is widely agreed that we could do better by using cost-effective analysis (CEA) to help determine which health care services are most worthwhile. American policy makers, however, have largely avoided using CEA, and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of EA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plans as examples. In exploring the disconnection between the promise of CEA and the persistent failure of rational intentions, the book seeks to find common ground and practical solutions. It analyzes the prospects for change and presents a roadmap for getting there. It offers pragmatic advice for cost-effectiveness analysts, discussing ways in which they can better translate their research findings into the basis for action. The book also offers advice for policy makers and politicians, including lessons from Europe, Canada, and Australia, and underlines the need for leadership to establish the conditions for change.
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Just when you thoght it was safe dismiss cost effectiveness analysis as another dry and broing topic, of interest only to geeky economists or hard hearted bureaucrats, a book has emerged that makes the subject unexpectedly compelling. The Harvard academic Peter Neumann passionately and eloquently articulates why we should all take more of an interest in how our health system gets value for money from medical treatments and technologies. More importantly, it shows why the country with the world's biggest and most dysfunctional health economy, the United States, has been so slow to embrace this tool for rationally making decisions about money and medicine . . . accessible, clear and unpretentious. (British Medical Journal)
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