Comparative effectiveness standards

by reader ilsm

From the Sunday June 14 Economist View discussion over Tyler Cowen’s article on Medicare crushing the federal budget, as the DOD budget has for many years. Tyler states the devastating growth of cost is due to “the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective” rather than insurance companies or profits of drug companies.

Imagine if the “comparative effectiveness” measure were applied to the warfare state.
In fact, an attempt at this was made by Sen. Levin in this new session; however, the bill that was passed is hugely watered down.
Weapon System Acquisition Improvement Act of 2009 See the link to section 101.

There will be a director of Cost Analysis and Program Evaluation. Appropriately acronymed: CAPE under which the incumbents will be hidden from any effectiveness.
There will be an attempt at using life cycle costs. And effectiveness (like has been on the books as long as I remember but not done).
There will be, finally, more thought about engineering management.
The teeth were in affirming the existing Nunn McCurdy, or unit cost acquisition procedures. There are so many loopholes in that paragraph there is no chance the warfare state will be delivering any measure of “comparative effectiveness” or pass any form of opportunity cost merit.

The main loop holes is here:

Sec 206 “Critical Cost Growth” from the wikisource link addresses large growth
in unit price or procurement costs. Can be beaten by not buying logistics
support and or cutting requirements, by this point likely already done. Later
in the section there are 5 or 6 loopholes the Sec Def can use to get around
terminating for critical cost growth. And they are reviewed by congress’
committees who will accept any excuse not to terminate a cash cow.

So, GAO will continue to report on the 95 largest programs taking too long to finish, costing too much, and delivering nothing for the resources consumed.

A refuge of charlatans is “being serious” about complying with laws that have so many loopholes their con is hidden.
by reader ilsm
(lightly edited for readability)

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