Patients who take a close look at medical science in search of treatments are often appalled by what they discover. On the one hand, there's academic research, a self-contained and self-absorbed universe of its own where data may be internally consistent (on a good day) and robustly reproducible, yet often has little relevance to real-world clinical conditions.

While it may be harmful and disingenuous to insist upon a single algorithm or best approach to practicing medicine, it could be helpful to at least provide clear guidance so that physicians would know to avoid certain therapeutic approaches.

This is an all too familiar story, the FDA impeding useful innovations in the US entrepreneurs here are forced to test promising medical devices in costly animal studies for years before they can advance their products into clinical trials. In response, American device makers are moving their business overseas.

A key government panel voted this month to whack what Medicare pays most doctors to treat patients. It's an important step on the path to ObamaCare--because the only way to make European-style health entitlements work in America is to pay US doctors lower European wages.

The core of medicine, and medical research, is and must be the patient, and the success of future drug development will depend upon our ability to keep patients in the front of our minds and at the center of our efforts.

Improved patient-focused measurement, while not perfect, could be profoundly enabling in the short term as well as beyond– but capturing this potential will require thoughtful science, involved patients, and inquisitive physicians, as well as the shared commitment to iterate and optimize around the common goal of improved health for real people.

The ability to make cost-effective exploratory efforts is a powerful enabler of innovation. Unfortunately, drug development is far less conducive to this sort of exploration.

As part of the AEI project Beyond "Repeal and Replace," health industry analyst Stephen T. Parente questions whether The American Recovery and Reinvestment Act of 2009 is likely to overcome longstanding economic disincentives to the use of electronic health records.