I read this statement by Senator Kerry in a New York Times article on regional disparities in Medicare spending earlier this week and predictably went crazy:
“There is too much uncertainty about the Dartmouth study to use it as a basis for public policy,” said Senator John Kerry, Democrat of Massachusetts. “Researchers can’t explain why some areas of the country spend more on health care than others. There are many reasons spending could vary: higher costs of living, sicker people or more teaching hospitals.”
“States like Massachusetts are concentrated centers of medical innovation where cutting-edge treatments are tested and some of the nation’s finest doctors are trained,” Mr. Kerry added. “This work might cost a little more, but it benefits the entire country.”
May I also add that sticking your head in the sand (a euphemism) and ignoring statistically significant differences in average spending per capita is no basis for public policy?<!--break--> We now turn to THE BEST BLOG POST I HAVE READ IN MANY YEARS by Maggie Mahar of the Health Beat Blog for a less snarky and more intelligent response to Kerry's quote:
No surprise, over more than thirty years, the Dartmouth researchers considered those possibilities. That is why the researchers adjust for differences in local prices, race, and the underlying health of population when making regional comparisons. Moreover, teaching hospitals do not invariably over-treat: one of Dartmouth’s landmark studies showed major differences in spending at Yale-New Haven and Harvard.
Kerry defends his home state. “States like Massachusetts are concentrated centers of medical innovation where cutting-edge treatments are tested and some of the nation’s finest doctors are trained. This work might cost a little more, but it benefits the entire country.”
Cost a little more? See this Boston Globe story about Partners HealthCare gouging patients in Massachusetts, charging far more for commonplace procedures while also ratcheting up volume. The Mayo Clinic is also a center of “medical innovation” and boasts “some of the nation’s finest doctors.” Yet it costs Medicare 50 percent less when patients are treated at Mayo than when very similar patients are treated at some of the nation’s most prestigious academic medical centers. And Mayo is not alone. The Cleveland Clinic, and the Geisinger Health System also serve as benchmarks for better care at a lower price.
Clearly, Kerry hasn’t read the research. Someone briefed him on it—and did it poorly.
Do Senator Kerry one better and read the whole thing -- as I said, the best blog post I have read in many years.