Thank you for your suggestion to reallocate health care dollars in California by refusing reimbursements for anything but evidence-based medicine. Your concept apparently is that reimbursable treatment must be limited to procedures that are scientifically proven to work. While I support ways of preventing unnecessary spending on health care or other state responsibilities, I have concerns about your concept.

Not all therapies can be proven scientifically to "work" on all patients. Antibiotic therapies, for example, don’t "work" in all cases. That doesn’t mean we should refuse to fund them if prescribed as necessary by doctors. Nor do I think any patient would want to be refused a treatment that might work in his or her case because it didn’t cure enough people in previous trials.

There is also the question of the scientific trials themselves. It would cost millions of dollars and take years for the state to test all medical modalities. The alternative is to depend on a random variety of past tests that may not include all treatments in question nor include representative California population samples.

We must all look for ways to assure that patients have access to the treatments they need -- even in tight budget years like this one. However, refusing to reimburse four-fifths of current treatments based on Dr. Schillinger’s findings that the trials he is aware of only support one-fifth of therapies, is too radical and would unnecessarily hurt too many people.

Sincerely,

JIM COSTA
Member of the Senate
16th District