Last night in the debate both candidates were asked about the causes of healthcare inflation. Neither could manage to spit out the simple fact that the majority of healthcare inflation is caused by people getting older and sicker, increased numbers of and cost of drugs, and the demand for more high tech diagnosis and treatment methodologies.

Increased usage of high tech diagnosis and treatment methodologies, even when expensive, is worth spending money on when it adds significant quality time to people's lives. Not quite such a good idea when it simply lines the pockets of the politically connected.

This morning the WashPost ran a story titled A Tale of Politics: PET Scans' Change in Medicare Coverage. Bottom line: in the case of $2,000-a-pop PET scans, slick lobbying and being buddies with a Senator trump science and cost the taxpayers big bucks for what is probably negligible positive health effects in diagnosing Alzheimers:

The first step, according to several people involved, was to persuade the Alzheimer's Association to soften its stance on PET. Then, they said, they played a card that had paid off for them before: a longstanding friendship between Michael Phelps, PET's inventor, and Sen. Ted Stevens (R-Alaska), chair of the appropriations committee that controls CMS's purse strings.

The Senate's senior Republican is famed for getting his way, often by refusing to bring spending bills to the floor until pet provisions are added. "It's never decided until we win," Stevens boasted last year.

Working with his chief health adviser, Elizabeth Connell, Stevens put that philosophy to work for Phelps by putting pressure on Medicare officials and on Health and Human Services Secretary Tommy G. Thompson ....

Especially under pressure at CMS was Tunis, the medical officer responsible for making the final decision. Underwhelmed by the evidence but well aware of the forces at work, Tunis finally crafted a compromise. Medicare would cover PET for the narrow purpose of distinguishing between Alzheimer's and FTD -- with specific restrictions to try to ensure that the technology's use would not grow beyond those bounds. In return he got something important, Tunis said: an agreement by PET interests to collaborate with CMS and the National Institutes of Health in a major study that might finally show -- if it remains free of political interference -- just what PET can and cannot do for Alzheimer's patients.

Along those lines, Connell had reassuring words for her audience at the meeting. She said she and Stevens had already written legislative language specifying that the Agency for Healthcare Research and Quality -- the evidence-demanding agency that managed the study recommending against broad coverage for Alzheimer's -- 'is not expected to be involved in this effort in any way.'

Too bad for John Kerry this story didn't run a day earlier ... would have made a nice talking point for him during the debate
  ¶ 11:18 PM