Expert Panels and Health Care Reform

A friend recently send me a link to a Wall Street Journal opinion piece by Norman Gleicher titled 'Expert Panels' Won't Improve Health Care. Here is part of my response: 

a) insurance companies all have panels now, but they are secretive, inconsistent, and dedicated to protecting their companies from meeting their contractual obligations 

b) government panels are more likely to be open, challengeable, and uniform–not necessarily better 

c) Dr. Gleicher is right that 'evidence-based' has much less evidence than the public believes. That would be the source of the article in my head (and likely never to see print) that is entitled "the evidence against evidence-based medicine". This article would point out that individual choice and variability, among other things, trump the evidence, especially in chronic illness. The other point is that 'evidence-based' usually is judged on a 1-5 year outcome, and may come to a completely different conclusion if the gold standard is a 10 or 20 year outcome.

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