Health Reform for Beginners: The Suprisingly Important, Occasionally Controversial, Dartmouth Atlas Studies
I'm not exactly sure how to convince you that this is an interesting link. It is, after all, a salvo in an ongoing methodological dispute between health-care experts. But it could be pretty important.
If you were to distill the administration's health-care reform theory down to two sentences, they would read something like this: As the graph atop this post shows, the cost of health care varies enormously between states, but there is no obvious connection between expensive care and better outcomes. Thus, the most promising goal for reform is to make the high-cost states look more like the low-cost states.
This theory is the product of the Dartmouth Atlas studies. The researchers behind those reports have spent the past three decades documenting the huge regional variations in Medicare spending and trying to discover if the differences in spending tracked differences in quality or outcomes. As far as they've been able to tell, there's no connection. On the strength of this data, members of the administration will tell you that the important comparison of health care reform is not between America and France, but Minnesota and Florida.
Critics, however, have argued that their data is fundamentally flawed. Spending differences, they say, are the product of sicker patients and the pathologies of urban life. If they're right, then the administration's approach to health reform is substantially based on a flawed study.
Over at the New York Times' Economix blog, Jonathan Skinner, one of the economists associated with the study, responds to those criticisms and explains what we know, and what we don't know, about the spending. It's worth a read. So is this post by health writer Maggie Mahar. And, if you want to go really deep, download anything on this page.
(Graph credit: Congressional Budget Office.)
June 15, 2009; 11:11 AM ET
Categories: Health Economics , Health Reform , Health Reform For Beginners
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