Expert panels have received criticism because of their science-driven approach based on risks and benefits. Those opposed to the idea of these panels argue that any economic approach to medicine does not take into account the value of a life. Others go to the extreme of saying that any analysis of cost-effectiveness or quality measurements of medical procedures leads to rationing of health care. As seen in the 2009 debate over changing breast cancer screening recommendations to be biannual starting at age fifty instead of annually at age forty, the public holds emotional value to procedures that can save lives; the chances hold little meaning. A similar controversy is present in the PPACA proposal to create a panel of experts who research and compare the clinical effectiveness of medical treatments. The goal of this panel is to maximize the effectiveness of Medicare-based care through patient-centered, outcomes based research, but those opposed to it fear that this group will only look at number-based evidence without taking into account real world issues involved in patient care.

Criticism

Medicare is a federally funded program administered by the government, so why should medical experts be influencing what procedures should be provided for under Medicare? This team of medical professionals has very little political experience and its individuals are very naïve to the politics involved with medical decisions. In the debate over breast-cancer screening, the medical experts did not understand the political backlash that their findings would have. The public was outraged by the decision and politicians dismissed their findings because of this. Decisions that affect the general public are inherently political; even with a staff of medical experts, the team cannot be shielded from political groups and opinions. By appointing individuals who do not understand the political turmoil that can arise from certain findings, the PPACA undervalues this connection.

Another criticism of this team is their purely scientific-based comparative research. With health issues and life saving treatments, the numbers in their comparative research hold little meaning. Those who survived breast cancer because of early detection were outraged by the recommendations to postpone mammograms, and rightly so. Comparative research and economic modeling does not transfer very well to real life when lives can be saved from the treatments offered.

Support

Those in favor of the fifteen member advisory committee argue that this research should be done by medical experts and should not have political influence. Improving access to quality and affordable care is the goal of PPACA, and this panel of medical experts aligns with that goal. This team is able to conduct comparative research to determine the best medical procedures that should be covered by Medicare. Political motivation should not drive health care reform, and with a team of medical experts, and not politicians, this is ensured. Politicians are driven by voters and lobbyists to make decisions that enhance their opportunities for election and reelection. This team does not face these outside pressures, so they are able to approach their research and their decisions objectively to provide better quality health care while controlling the cost of Medicare.