“YouCut” and CER: Coalition Advocacy at Work

Over the last two years, the American Recovery and Reinvestment Act (ARRA) and the Patient Protection and Affordable Care Act (ACA) sparked an infusion of funding and support for our field and created immense opportunities. There is no question the winds in Washington have shifted dramatically and our field is now caught in the crosshairs of a political and fiscal debate that will not end quickly or easily.  Not only is the level of research funding threatened, the very role of government in research is being questioned. Events in Washington over the last week provide a taste of what our field will face, and your role in protecting it.   On June 14, the Government Accountability Office  released an inventory of ARRA and ACA funding of comparative effectiveness research (CER), both the $1.1 billion provided to AHRQ, NIH, and HHS through ARRA and the funding made available to HHS through the new Patient-Centered Outcomes Research Institute (PCORI) established by ACA. The report—which was mandated by the fiscal 2011 Continuing Appropriations Act—provides the first comprehensive summary of the expenditures HHS has made using these funds, the entities that have received such funding, and the purpose of the funding.  Hours after GAO released its report, the backlash began. A health policy aide to the Senate Republican Policy Committee expressed concerns about the funding, questioning the value of initiatives designed to help patients and their clinicians access and use comparative effectiveness research in making decisions about care.  “At a time when the federal government is running trillion-dollar deficits, many may question the point of granting over $26 million to PR firms for a 'Publicity Center' – and spending taxpayer dollars on research that could be used to deny vulnerable patients care,” said the aide, on record.  Just days later, AHRQ’s CER portfolio was featured on YouCut, a website run by House Majority Leader Eric Cantor (R-VA). YouCut is designed to “defeat the permissive culture of runaway spending in Congress,” allowing the American public to vote, both online and via cell phone, on spending cuts. The site assures that “each week that the House is in session, we will take the winning item and offer it to the full House for an up-or-down vote, so that you can see where your representative stands on your priorities.” The site inaccurately described AHRQ’s comparative effectiveness research as duplicative and potentially restrictive to patient choice, saying:

“The work funded through AHRQ is often duplicative of research being conducted through the private sector or other health care agencies throughout the federal government…Critics of the agency note that the type of research being conducted by AHRQ could be used to develop policies that may restrict access to care for treatments and services based on cost...”