Where have all these critics of the Dartmouth Atlas data been all these years?

Amitabh Chandra, Professor of Public Policy at the Harvard Kennedy School of Government, responds in Health Affairs to what Maggie Mahar calls "critics of the Dartmouth research who have suddenly emerged from the woodwork, (after more than twenty years and more than 100 peer-reviewed publications supporting the work done by Jack Wennberg, Elliott Fisher and others.)" Excerpts:

"Today, the Dartmouth Atlas finds itself yanked from the tranquility of Hanover, New Hampshire, and placed squarely in the crossfire of health care reform debates in Washington. Its insights offer enormous promise for managing cost growth in health care. Because health care is almost 20 percent of U.S. gross domestic product (GDP) and is growing at 6.5 percent annually, it is perhaps unsurprising that the Dartmouth group finds itself under attack; all that spending is someone's income. Some attacks come from beneficiaries of the status quo: financially entrepreneurial providers, such as those in Redding, California, McAllen, Texas, and Elyria, Ohio, have much to lose. Others, including myself, worry that if the Atlas's findings are misinterpreted or oversimplified, they will result in sledgehammer policies that can damage an already injured health care system. ...


Congress needs to encourage Minneapolis-type care to emerge in Miami, while curtailing the incentives for Minneapolis to morph into McAllen. This involves doing much more than offering piecemeal adjustments to the reimbursement system. It requires rewarding the creation and expansion of already existing delivery systems that have the right incentives to check costs while delivering quality. It requires competition between these delivery systems for patients and their premiums. It requires that Congress and the president have the courage to fight the beneficiaries of the status quo, who have already begun to launch a bitter fear-campaign against attempts to implement accountability and value. These are the lessons that I've learned from the Dartmouth research program."

About this Entry

This page contains a single entry by Gary Schwitzer published on June 18, 2009 10:59 AM.

Willy Wonka and health care reform in the heartlands was the previous entry in this blog.

Another glimpse - this time from Oklahoma - of fawning news of medical technology is the next entry in this blog.

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