In 1996, David Sackett ,M.D." said, “Evidence-based medicine (EBM) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” This is the essence of modern medicine that uses the scientific method in patient care decision-making.
With free-market medical care, patients chose their doctors and their doctors determined what they considered the best treatment using EBM. Physicians read textbooks, studied the literature, and went to meetings where they assimilated the opinions of experts about diagnoses and treatments.
They would also talk with their colleagues about the various experts or researchers ideas. Using all these sources, individual physicians would determine what they thought was the best treatment. These treatments set the standard of care.
However, this is not how the government plans to use EBM. The government has an abstract on the “history and development of evidence-based medicine.” “Experts” would create guidelines from a “systematic review” of all the available data systems. Their guidelines would become the standards of care.
In order to be reimbursed, physicians would have to use these guidelines in the treatment of their patients. Later on, Doctor Sackett seemed to have reservations about the process and advocated term limits for the “experts.”
The U.S. Department of Health & Human Services has a “National Guideline Clearinghouse. As with any government policy, politics enters the picture. Will a drug be chosen because of its merits, because of its costs, or because one drug company has the better lobbyists along with higher campaign contributions?
Of course there is no perfect system and humans are not angels. Perhaps Milton Friedman made this point best when he said, “Is it really true that political self-interest is nobler somehow than economic self-interest? You know, I think you’re taking a lot of things for granted. Just tell me where in the world you find these angels who are going to organize society for us?”