From an economic perspective, health reform will fail if we can't sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare's long-term budget deficit will grow.
So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. "Being able to say no," Dr. Alan Garber of Stanford says, "is the heart of the issue." ...
None of these steps will allow us to avoid the wrenching debates that are an inevitable part of health policy. Eventually, we may well have to decide against paying for expensive treatments with only modest benefits.So there will be "new agencies" who "can (will) say 'no'" to treatments. It will be up to the agencies to decide if the benefits are "expensive" and deliver "modest" benefits.
And up to the