America spends more than 14 percent of its gross domestic product (GDP) on health care each year. Every modern-day president has declared that he would lead action to reduce the continuous trend of growth. Each has declared that the nation cannot afford more. Yet, advances in research, technology, marketing, population age, and more continue to come together to push national health spending higher each year.
Real health care inflation is high relative to overall inflation, health insurance premium growth is at historically high levels, individuals are being asked to pay more when they seek health care services, and the Internet—more than any other advance of the modern age—has made it possible for the inspired individual to become an "informed" health consumer by placing the contents of thousands of libraries a simple mouse click away. We know, however, that not everything is on the Internet, and some of what is there may not be of actual value or may simply be wrong.
How can individuals find what is right, or best, or proven? How can the health system be moved to do a better job of testing, documentation, communication, and performance? How can individuals find what is right (or best) or proven, and can they determine what's best for them personally? Will increased evidence-based care stabilize or accelerate cost inflation?
Annual double-digit increases in the cost of providing health benefits have proven to be an engine for experimentation, testing, and adoption of new approaches. Yet, the health system and decision-making are still highly fractured. Where evidence-based medicine has been developed, it cannot always be effectively communicated, and even if communicated, it cannot always be effectively used for decision-making.
About a hundred leaders of the health sector, policymakers, employers, labor representatives, and others examined the promise, the obstacles, and the realities of evidenced based medicine during the Employee Benefit Research Institute's May 8, 2003, policy form: "Will Wider Use of Evidence-Based Medicine Significantly Enhance Health Care Quality and Affordability? Implications for Consumer-Driven Health Benefits." The papers contained in this book, based on the policy forum's proceedings, explore in detail the research that has been done on the topic and the implications for consumers, business, and government.
Evidence-Based Medicine provides a comprehensive review of how much has been done, and also the challenges that lie ahead if "evidenced-based" medicine is to become the rule rather than the exception, and if consumer-driven health care is to allow the consumer to have full information on all possible treatments and procedures and the evidenced-based efficacy of all of them.