In health care as elsewhere, cheaper is not always better.
So the dirty little secret has come to light. As it appears, in health care, cheaper is not always better. The “pioneering” research produced by the Dartmouth group, propagating the belief that many areas of the country spend more in health care than others, while providing no better, and sometimes worse, care (the study used comparisons within Medicare) because in these regions doctors are simply “wasteful”, may have been based on faulty research after all.
At least this much was admitted in a recent article in the New York Times, even as the very New York Times editorial board, and key reporters such as David Leonhardt, have been all along major supporter of the science and philosophy underlying Dartmouth and of the many “cost-saving and quality improving” measures that will be implemented under the new law, the “Patient Protection and Affordable Care Act”. One key measure is to reduce “superfluous” services to Medicare patients, and thus “rein on waste, fraud and abuse“. Somehow, this will not undermine, but rather improve, the quality of care provided to them, or so says the law.
Indeed, for New York Times editors one key problem in our health care system has been all along the “profligate” behavior of doctors. If we can tame this behavior, our collective savings will be extraordinary, the Times and its health reporters have asserted repeatedly, and will enable us to eventually provide health care to all Americans at lower costs. Promoting this view, The Cost Conundrum, by Atul Gawande, a Harvard-affiliate doctor and author, became “required reading” in the White House, and turned its author into a Washington star virtually overnight.
But as it turns out, the research may have been faulty.
Just so as not to clog cyberspace with redundancies, here an excellent analysis of what the Dartmouth study really showed (you guessed it: correlation is not causation), and what may have been the motivations of researchers who promoted the study (you guessed it: money!).
Single payer anyone?
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