FOR IMMEDIATE RELEASE,Tuesday, June 12, 2007
CONTACT: Yoni Cohen, Stark (202) 225-3202

WASHINGTON, D.C. -- Representative Pete Stark (CA-13), Chairman of the
Ways and Means Health Subcommittee, delivered the following opening
remarks at today's hearing on strategies to increase research and
information on comparative clinical effectiveness.

“Good Morning. Today is another in our series of hearings on how to
improve Medicare. Today we’ll focus on long-term solutions to increase
and assure the value of our health care expenditures – in Medicare and
elsewhere -- by increasing research on comparative clinical
effectiveness.

“Comparative clinical effectiveness means comparing the relative value
of different clinical treatments, including drugs, devices, tests,
procedures, bandages, pills and anything else you want to take and try
to get a comparative ranking. All too often physicians and patients
struggle to understand when a new product, diagnostic test or surgical
procedure will be most helpful, or how to choose among existing courses
of treatment.

“Given the dearth of good information on comparative clinical
effectiveness, it’s hardly surprising that GAO and MedPAC find dramatic
variation in the use of medical services across regions, providers and
specialties. Even worse, researchers find that areas with the highest
use of some services aren’t necessarily linked to higher quality care or
better outcomes. To the contrary, beneficiaries may be put at greater
risk when they are subjected to more -- and more complicated -- tests
and treatments.

“As Medicare’s Board of Directors, Congress needs to ensure that
Medicare resources are being used effectively and efficiently to provide
high quality care and achieve the best possible outcomes. Getting
reliable, unbiased comparative information is our best shot at
controlling health spending while improving care and access. Even if Dr.
Orszag won’t give us savings immediately for our efforts, we can
identify ways we can get the information we need to achieve this
important goal, and lay the groundwork for a more efficient, effective
system.

“Health policy experts across the political spectrum advocate that
comparative information is sorely needed for the public good. They argue
that greater investment in comparative effectiveness research is
critical to assuring high-quality care and reducing unnecessary
expenditures. Better information about the relative strengths and
weaknesses of various products, procedures and services will help
physicians and patients make wise decisions and will help public and
private payers equitably manage rising health care costs.

“Many countries have already made major investments to provide this
information to physicians, patients, and policy makers. It’s high time
that we do the same!

“Many of my colleagues urge that we should “pay for performance.” We
already do that – providers perform, and we pay. It’s just that we pay
the same whether the service is done on the right people at the right
time -- or the wrong people at the wrong time! We really have to know
what the effective and appropriate services are before we can know how
to reward the care that achieves the best outcomes.

“Various authorities both within and outside government have called for
a substantial national investment in comparative effectiveness
information, and have identified issues and options to help us determine
optimal financing and governance for this activity. My personal
preference is to move toward a system that is accountable, yet
independent, and free from both industry and political influence. Let
me repeat that, free from both industry and political influence. Both
clinicians and patients need to be confident that this work has been
done in the best interest of the patient. To me that points to a
government-led effort.

“We are fortunate to have with us today some of the leading experts as
well as representatives of the prominent stakeholders.

“I am particularly pleased to welcome our first witness, Congressman
Allen from Maine, who been a leader within the House on the issue of
comparative effectiveness, and has recently submitted legislation to
address this problem. Subsequent witnesses will also enlighten us on
this critically important strategy to improve health care in the US, and
I look forward to their testimony and the ensuing discussion.

“Thank you.”