Through the Looking Glass

Soon after his swearing-in, President Barack Obama issued a memorandum to all federal agencies advocating greater transparency in government actions. Obama also called for high ethical standards for government officials, a stance that helped derail the confirmation of Tom Daschle as Secretary of Health and Human Services (HHS).

Reformers regard transparency in healthcare costs, provider practices, and drug and medical product performance as critical to informing prescribing decisions, driving down expenditures, and expanding access to affordable care. One problem with the nation's healthcare system is a lack of transparency in financing, pointed out Robert Reischauer, president of the Urban Institute, at a recent health policy meeting. "Few people understand what things cost or who pays the bill."

Proposals to expand adoption of health information technology and fund comparative-effectiveness research could also increase transparency. And objective comparisons of treatment effects would supplement basic safety and efficacy information required by FDA and support appropriate treatment.