Cost Analysis of Medicare Cases Attacked

A proposed rule calling for cost-benefit analysis of new types of medical care for the elderly could put additional burdens on Medicare recipients, critics said Sunday.

A federal health official, however, said the regulation would not be used to block the availability of new technologies that provide “clear advances or benefits.”

“Up until now, cost has had no consideration,” said Gail R. Wilensky, head of the Health Care Financing Administration. “We are just trying to bring it into the calculation.”

The rule, which is awaiting adoption, would require the federal government for the first time to compare costs and benefits of specific types of care in deciding whether to pay for them.

Gordon B. Schatz, a lawyer who specializes in health care issues, said: “I find it a little paradoxical that a program designed to protect senior citizens against cost now may be stepping back from its public obligations to protect them just because something may be too expensive.”

Wilensky said cost would not be used as the sole determinant, but would be only one factor--along with the benefits, safety and effectiveness of the new device or medicine.

Schatz, who is familiar with the proposal, said the regulation is evidently a response to budgetary restraints brought on by the federal deficit.

Horace B. Deets, a top official of the American Assn. of Retired Persons, said he wasn’t familiar with the rule but worried that it, like other proposals to deal with health costs, would merely “shift the cost perhaps from the government to individuals.”

Wilensky said she had sent the proposal to Health and Human Services Secretary Louis W. Sullivan for his approval.