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Dartmouth College Office of Public Affairs • Press Release
The United States can extend coverage to the country's uninsured without substantially increasing overall health care costs, according to a Dartmouth Atlas white paper released today by The Dartmouth Institute for Health Policy and Clinical Practice (TDI).
"Most analyses of coverage reform predict that we will spend more as a nation on health care once the uninsured gain coverage and begin consuming more care," write lead authors John E. Wennberg and Shannon Brownlee. "But we predict that covering everyone will have a much smaller impact on the trend in health care costs, provided that capacity is not increased." Co-authors of the paper are Elliott S. Fisher, Jonathan S. Skinner, and James N. Weinstein, all of TDI.
Not increasing capacity while improving quality and increasing coverage, say the authors, can be achieved in a number of ways, including reducing oversupply of health care services in high spending regions of the country. As documented repeatedly over 20 years of research by the Dartmouth Atlas Project, more spending on health care, more procedures and more hospitalizations, do not result in better health outcomes for patients.
The paper, An Agenda for Change-- Improving Quality and Curbing Health Care Spending: Opportunities for the Congress and the Obama Administration, presents four priorities for achieving true health care reform:
"Comprehensive health care reform is not only possible, it is imperative. Conventional wisdom would asset that in the current financial crisis, we cannot afford to embark on reform, and that Americans are not prepared to stomach dramatic changes in either their coverage or the way care is delivered," write the authors.
"But a recent survey published in the New England Journal of Medicine reported that 70 percent of respondents believe that the system needs major changes, if not a complete overhaul...We believe that affordable, high quality health care coverage should be the goal. The way to achieve that goal is through fundamental changes in the delivery system, and the time to begin making those changes is now...The wealth and health of the nation depend upon it."
John E. Wennberg is the Founder and Director Emeritus of The Dartmouth Institute for Health Policy and Clinical Practice and of the Dartmouth Atlas Project. He holds the Peggy Y. Thomson Chair in the Evaluative Clinical Sciences. Shannon Brownlee is a Visiting Scholar at the National Institutes for Health, a Senior Fellow of the New America Foundation, a Woodrow Wilson Fellow, and the author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, published by Bloomsbury Press in 2007.
Copies of the paper can be downloaded at the TDI web site.
The Dartmouth Institute for Health Policy and Clinical Practice is a dynamic force within Dartmouth College, dedicated to improving health care through education, research, policy reform, leadership improvement, and communication with patients and the public.
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