Dr. Abramson sees the solution to our cunundrum as more government oversight of the healthcare industry. He suggests we set up an impartial body, along the lines of the Federal Reserve Board, to monitor the quality of medical research and recommendations. In addition, he suggests that there be government funded universal healthcare coverage, which would pay only for those benefits deemed worthy by the oversight board. Dr. Abramson puts too much faith in the impartiality of government bodies. Even the Federal Reserve Board comes under criticism for being entirely a creature of the finance sector. The Institute of Medicine, which he also mentions as a model, is no less subject to bias. Their report on racism, for example, was written by people whose careers depend on the presence of racism. Their personal bias was to see racism even where it doesn't exist. Similarly, their report on errors in medicine was written by people who make their living selling safety systems and consulting on error reduction. Not surprisingly, the racism panel claimed racism was rampant (later debunked) and the error panel claimed more errors than statistically reasonable. Imagine what they would do with something like drugs and therapuetics which are much more subject to lobbying influence.
History tells us that there's very little reason to expect our government to be immune to industry lobbying. As we've seen with Medicare spending and NIH research funding, all it takes is a celebrity or a Congressional relative with a disease to earmark money for its treatment. They're even more prone to influence from those advocacy groups and lobbyists who have the money for campaign donations.
A better solution would be to move the decision making process, especially for preventive care, back where it belongs - between a patient and his physician. The only way to do this is for the patient to share at least some of the financial responsibility for their care. As long as someone else is paying the bill, the sky will be the limit. It's just human nature. A patient who has to pay for cholesterol lowering medication is going to be much more likely to question its benefits, and the doctor who has to justify the expense to his patient it is going to be much more willing to critique the evidence. This, of course, flies in the face of all that is politically correct in medicine. But, as Dr. Abramson so ably points out in his book, we aren't really getting very much in return for all of this very costly prevention. Isn't it about time that we all took responsibility for our share of the mess?
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