Healthcare Research Cited by W.H. Said Flawed

Thursday, 03 Jun 2010 10:04 AM

By Dan Weil

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Research cited by the Obama administration as proof that it can cut wasteful healthcare spending and improve treatment at the same time proves no such thing, The New York Times reports.

The work by a group at Dartmouth College supposedly showed which hospitals charge more and give worse care than others.

But that’s not the case. “The Dartmouth researchers themselves acknowledged in interviews that in fact it mainly shows the varying costs of care in the government’s Medicare program,” The Times reports.

“Measures of the quality of care are not part of the formula.”

The Dartmouth group produced color-coded maps in the Dartmouth Atlas of Health Care to show where the wasteful spending is. Brown indicated hospitals and regions that offered expensive and inadequate care, and beige showed hospitals and areas where the reverse is true.

Members of Congress using the maps demanded that the Obama administration just cut Medicare payments to hospitals and doctors in the brown zones. And White House officials said they’d indeed consider that.

Obama’s budget director Peter Orszag, who displayed the maps himself, wrote in a blog that wasteful spending of perhaps $700 billion a year “does nothing to improve patient health but subjects you and me to tests and procedures that aren’t necessary and are potentially harmful.”

Yet the Dartmouth group’s research is quite limited, The Times points out.

“For all anyone knows, patients could be dying in far greater numbers in hospitals in the beige regions than hospitals in the brown ones, and Dartmouth’s maps would not pick up that difference.”

“Even Dartmouth’s claims about which hospitals and regions are cheapest may be suspect.”

The researchers claim that doctors in the Upper Midwest provide superior and cheaper care than those in the South and in big cities.

“But the real difference in costs between, say, Houston and Bismarck, N.D., may result less from how doctors work than from how patients live,” The Times explains.

“Houstonians may simply be sicker and poorer than their Bismarck counterparts. Also, nurses in Houston tend to be paid more than those in North Dakota because the cost of living is higher in Houston. Neither patients’ health nor differences in prices are fully considered by the Dartmouth Atlas.”

All the Obama administration’s arguments may prove moot in the end, as 20 states have filed a lawsuit challenging the constitutionality of the healthcare reform law.


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