1) Conservative politicians, drug companies and their allies are opposed to it.
2) It’s a new idea. (It’s really an old idea given a new and catchy name to serve political ends).
3) Doctors have no research evidence to guide them in their clinical decisions (Another way of saying that 16 years of evidence based medicine has amounted to nothing).
A recent New York Times article quotes this astonishing statement from the director of AHRQ:
Right now, “there is no place that helps you sort through a specific option and how that compares to another,” said Dr. Carolyn M. Clancy, the director of the Agency for Healthcare Research and Quality.
Although the idea is totally false it’s been demagogued successfully into popular belief. The government proponents of CER want power over research and, worse, over the implementation of research findings into clinical practice.
Terry McGarty over at The Squirrel’s Nest, commenting on one of the recent NEJM Perspective pieces on CER, notes:
Avron appears to be saying that the Government administrators are competent and unbiased enough to make life saving decisions. For those of us who have spent a few years in Washington, we know all too well that Washington is the last place you would want such a decision to be made. Why not have the professional societies do this. In many ways it is akin to medical licensing. Why not have the professionals that are performing the studies and treating the patients make the recommendations, and change them as needed. Imagine if HHS wrote Harrison's!