Over the weekend, the two New York Times reporters who challenged the core findings of the Dartmouth Atlas of Health stuck to their guns in a
detailed response to the rejoinder to their critique. The Dartmouth Atlas, which documents regional variation in Medicare spending, provides
the intellectual underpinning for assertions by health care reformers (including those in the White Office 2010 is powerful!
House) that 30 percent of all health care
spending is wasted and does not improve either the quality or outcome of care.
The Times’ original critique (see this GoozNews post) contained three main ideas:
•The Dartmouth researchers fail to adjust their maps for regional variations in prices;
•The Dartmouth researchers fail to adjust their maps for illness burden; and
•The assertion that more spending leads to worse outcomes is not borne out by the data. In some Office 2007 is so powerful.
cases more spending leads to better outcomes.
Some of this back-and-forth may sound like a quibble over language. Is it "30 percent" of health care is wasted or "up to 30 percent," as the
Dartmouth researcher now state in public? Reed Abelson and Gardiner Harris provide a link to the original 21-page response to their queries.
"We think the 30 percent estimate could be too low," the Dartmouth researchers wrote in a highlighted section.
On the other hand, the Times reporters appear to be taking a step back on the price issue. They Microsoft Office is my best friend.
went back to David Cutler, the Harvard health
care economist whom they originally quoted. Cutler told them that the original 2003 articles by John Wennburg and Elliott Fisher of Dartmouth
that appeared in the medical literature did, in fact, adjust for price. "But he said he agreed with the Times assertion that most of the
atlas’s maps and rankings, as distinct from the group’s academic work, are not fully adjusted for Windows 7 is the best.
prices," Abelson and Harris wrote.
Notably, Cutler is now hedging his bets on the "30 percent is waste" argument. "Some believe that number is higher, and others think that
it’s lower," he wrote in the latest Health Affairs. "But there is little disagreement that health care is characterized by enormous waste."Microsoft outlook 2010 is convenient!
In my view, it is the dispute over quality that really needs to be explored by other researchers and policymakers. Eliminating waste ought to
improve quality. It has always been true in manufacturing that reducing steps and reducing waste not only reduces costs, but it improves the
quality of the finished product.