Cost Effectiveness as a Criterion for Medicare Coverage

In a Sounding Board article, a physician comments upon and solicits for the proposed rules for Medicare coverage issued by the federal Care Financing Administration in January 1989. The regulations propose cost-effectiveness be included as a criterion for Medicare coverage of a or procedure. Leaf points out that many medical procedures in usage never have been subjected to rigorous clinical testing to their medical- or cost-effectiveness. He urges the development of, less expensive methods than the randomized, double-blind, -controlled clinical trial to evaluate efficacy. Leaf also calls for a definition of the goals of the American health care system, whether objective is increasing life expectancy or helping people remain in good for as long as their biological life span permits. (KIE abstract)