PEDIATRICS Vol. 96 No. 6 December 1995, pp. A40
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If HMOs Want Evidence-Based Medicine, They Should Pay for Studies!

J. F. L. MD

Some managed-care organizations are keen to support research. Kaiser-Permanente (which started life in California during the 1930s and now operates in many states) and Group Health Co-operative of Puget Sound (in Seattle) have for decades entered their patients in NIH-sponsored trials and conducted their own studies ... Several newer managed-care firms have followed suit.

... In the insurance industry, attitudes to research range from lukewarm to hostile. Lee Newcomer, medical director of United Health Care, a huge managedcare organization based in Minneapolis, says his firm would be more enthusiastic about paying for it if fewer clinical trials were "too small, too poorly designed, and too poorly organized" to answer questions about which treatments—particularly the most complex and costly—are worthwhile.

William Roper, a former health official in the Reagan and Bush administrations who is now Dr Newcomer's counterpart at the Prudential Health Care System in Roseland, New Jersey, goes further. He agrees that research is important, but he also argues that researchers have been too little accountable for how they have spent the public dollars that have flowed their way. "Why," he asks, "should society be paying extra for the delivery of health care at academic institutions merely on the presumption that it is getting something of value?" Prudential's position—unless Congress decides to tax all managed-care companies to support research—is that it will not pay for experimental medicine.