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Correspondence
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Volume 351:719-720 August 12, 2004 Number 7
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Medicare Coverage for Technological Innovations

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by Tunis, S. R.
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by Gillick, M. R.
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To the Editor: The Sounding Board article by Gillick and the accompanying editorial by Tunis (May 20 issue)1,2 illustrate why it is so hard for Medicare to make coverage decisions that are fair and acceptable to all parties. Too many stakeholders misunderstand and mistrust the complex and often opaque systems through which coverage decisions are made. But the lessons drawn are too narrow. Most important, we need systemwide attention to the ethics of decision making with regard to coverage — not just greater use of cost-effectiveness data and not just in the Medicare system.

Although substantive criteria for coverage may . . . [Full Text of this Article]



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