Inside the "Death Panels"
Dr. Craig Henderson ’63 recently brought his perspective on health care reform to the Grinnell campus in his talk, “A View from Inside the Death Panels,” sponsored by the Wilson Program. Dr. Henderson presented a contrast to the controversy that has surrounded “death panels” in recent months by providing detailed and valuable insights into how a real-life panel operates.
Dr. Henderson, one of the nation’s top cancer experts and a Grinnell trustee, served on the Harvard faculty for 18 years and was CEO and chair of SEQUUS Pharmaceuticals, a biotechnology company. Today, he is a member of the Medical Advisory Panel of Blue Cross Blue Shield (BCBS), a confederation of 39 independent health insurance companies that collectively insure approximately 100 million Americans, or one-third of the population. The group is an advisory panel that reviews various treatments and tests to determine whether they meet preset criteria of safety and effectiveness.
Dr. Henderson explained that about two-thirds of the panel’s members practice medicine and see patients on a regular basis. He described the panel’s function as “evaluating the results of comparative effective research.” Of the roughly 20 voting members, the majority are not BCBS employees, and the group includes medical organization representatives, statisticians, and an ethicist.
The panel evaluates new surgical procedures, drugs, laboratory and radiological evaluations using a list of five specific criteria, including the amount of scientific evidence available and the quality of the studies involved. Popular perceptions about the efficacy of health care, though, are often not consistent with the panel’s conclusions, Dr. Henderson said.
Public pressure can compete with effectiveness data to influence coverage decisions, Dr. Henderson said. He cited the case of a procedure to relieve the pain of fractures caused by osteoporosis. Early studies and anecdotal evidence gave it the status of a miracle cure, and the use of the procedure doubled from 2003 to 2009. Several insurance companies covered the procedure. The panel, however, concluded that there was insufficient evidence to draw conclusions about its efficacy. Later, two randomized, double-blind studies reported in the New England Journal of Medicine found that the procedure had no beneficial effects.
According to Dr. Henderson, panels such as this fulfill an important role in exploring these vital questions as the nation tries to come to an agreement about health care reform.
Originally published as an online web extra for The Grinnell Magazine, Winter 2009