The House Appropriations Committee for the Departments of Labor, Health and Human Services, Education and related agencies voted to “terminate” the Agency for Healthcare Research and Quality (AHRQ). It also voted to prohibit funding for patient-centered outcomes research (PCOR), along with hefty cuts for public health.
In considering this decision, I am struck by the strain of conservative politics which is so actively hostile to the craft of scientific research, evidence-based policy, and empirical analysis. This hostility is most obvious in the domains of climate change and economic analysis of tax policy. Yet this hostility is more broadly expressed, as well, for example in opposition to rigorous health services research.
It is beyond foolish to spend $2.8 trillion on health care without examining the quality of medical services, without exploring the link between services provided and subsequent patient outcomes. These are the core functions of AHRQ and PCORI, two small but extremely valuable federal efforts in health policy.
Congressional committee chairs (in both parties) dislike the way that comparative effectiveness analysis competes with political bargaining in making difficult resource allocation decisions. More than a few medical specialty societies, pharmaceutical firms, imaging manufacturers, and medical device-makers don’t like the unflattering conclusions of various comparative effectiveness studies. Slamming AHRQ and PCORI may advance Republicans' short-term partisan interests. The real issue is broader. Such attacks provide convenient cover for traditional special-interest politics. In the long-run, such crazy congressional committee votes seriously hinder both parties' efforts to enact better, more evidence-based health policies.