The trustees for the Medicare and Social Security trust funds recently announced — again — both funds would run out of money by 2024, five years sooner than they projected in 2010.
 

Proponents of Obamacare are claiming that but for the Independent Payment Advisory Board — which issues binding recommendations on cutting Medicare spending — the situation would be even worse.
 

They say the advisory board, using comparative effectiveness research to determine whether we can afford paying for medical innovations, is the key to avoiding financial Armageddon. But our research shows that using CER to ration medical progress could shorten lives and affect health.
 

Because Medicare spending declines as people live longer and healthier, CER will undermine the health and longevity of Medicare, too. CER's underlying assumption is government — through the advisory board and other government agencies using CER to decide what technologies to cover — will have to draw the line on health care spending somewhere and that "somewhere" should be medical innovations.
 

In fact, the advisory board is prohibited from increasing co-payments or deductibles for Medicare recipients and can't cut reimbursement rates to hospitals until 2020. So the only way to cut spending by fiat is to slash what doctors get paid or say no to new technologies.
 

But the assumptions underlying the advisory board and CER are dangerously flawed. Living longer and healthier is directly associated with increasing investment in medical innovation.
 

Since 1992, Medicare beneficiaries have been living healthier lives past age 65, while disability from chronic illness has declined at an increasingly faster rate. What effect would CER have on this positive trend? CER is designed to add to the cost and time required to bring innovations to market. And because CER is a precondition to making coverage decisions, CER studies looking at how technologies affect the average patient would de facto become a regulatory requirement.
 

These regulations would increase the sizes of clinical trials, increase development times, and add hundreds of millions of dollars to the cost of developing innovations. CER proponents say it frees up money for other needs.
 

But because CER could ration innovations such as Avastin for late-stage breast cancer patients, we would give up improvements in our health and longer life that also help reduce Medicare spending.
 

What would be the impact on America and Medicare? We used a conservative benchmark for what an additional year of life could be worth to each of us ($50,000) to develop an estimate of what CER could cost America over the next decade. An estimated $32 billion reduction in R&D could cost us 81 million life years and $4trillion over 20 years.
 

Jonathan Skinner, a health economist from Dartmouth and a leading CER advocate, believes "the antagonism toward comparative effectiveness research ... suggests a bit of magical thinking — the notion that the country can avoid the difficult trade-offs that cost-utility analysis helps to illuminate ... It represents another example of our country's avoidance of unpleasant truths about our resource constraints."
 

In fact, it is CER proponents who are avoiding the truth. Our research shows CER could lead to shorter lives in poorer health by restricting and rationing the rate of innovation.
 

Our study confirms what Yale economist William Nordhaus has concluded: "The social productivity of health care spending might be many times that of other spending. If this is anywhere near the case, it would suggest that the image of a stupendously wasteful health care system is far off the mark."
 

And it suggests CER not only undermines making Medicare whole, it's dangerous to our health and quality of life, too.