David Leonhardt's "Economix" column in the New York Times yesterday argues that we don't need to restrain health care costs. He writes, "we often imagine that the costs and benefits are unrelated, that we can somehow have 2006 health care at 1950 (or even 1999) prices. We think of health care as if it were gasoline, a product whose price and quality have nothing to do with each other."
The column is, perhaps, an example of how you can't plunk an economist down in the health care industry and expect him to make sense of it. The column is blind to some of the hard data-driven realities of the U.S. marketplace.
2006 health care is not a hallmark of quality. As Dartmouth's Jack Wennberg has established over more than 30 years of research, there are wide, unexplained variations in the way medicine is practiced in this country, driving him to say, "In U.S. healthcare, geography is destiny."
Elliott Fisher of Dartmouth has shown that more is not always better in health care - that high-spending areas may have worse outcomes than low-spending areas.
Former U.S. Senator David Durenberger (R-Minn.) is eloquent on the point that we don't know what we're buying in health care.
So Leonhardt's argument that "an affluent society should devote an ever-growing share of its resources to the health of its citizens" is simplistic. Why encourage more spending in an arena of uncertain quality, where more is not better, where we don't know the value of what we're getting now for our unprecedented 15% of the GNP in health care???
Posted by schwitz at September 28, 2006 07:51 AM | TrackBack