Loser-free health-care reform
To say another word about the fuss over the Dartmouth Atlas project, it's worth talking for a minute about why people so badly want the project's conclusions to be right.
The Dartmouth Atlas project has amassed an enormous amount of data suggesting that up to 30 percent of our health-care spending goes to items that don't do anyone any good. It's wasted money. If this is true, it's absolutely great. Or it at least has the possibility to be great. It means we don't have to ration.
We know that we're going to have to eventually cut health-care spending by quite a lot compared with what it would be if we don't do anything. There are probably three ways to do that: Make care less affordable (high co-pays, for instance), less accessible (waiting lines) or less profitable (government bargaining). All of those approaches will have losers. Lots of them, in fact.
But if the Dartmouth Atlas project is right, and if its findings can somehow be put into policy, it offers a loser-free way out of our predicament: You take away care that no one needs. That means no one loses. In fact, some people win, as unnecessary care carries risks of its own. That's much easier for politicians to sell, and it looks like it's actually true. The only question is whether we can figure out how to separate the good care from the bad. And we won't know that for years to come.
United States - Politics - Health Care Reform - Dartmouth Atlas - Health care
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The savings don't matter
It is funny how no one seems to object when an unnecessary procedure is done, but deny someone that right to that "unnecessary" procedure and you have a fight.
And the argument is always, "My doctor said..."
About ten years ago, my wife had a surgical procedure done that worked wonderfully well to resolve her symptoms.
Her current doctor never stops reminding her how lucky she is that this has worked for so long. She claims that my wife is among a rare group of individuals who have experienced long term benefits from this procedure. For most, per this doctor, they are lucky if they only return to pre-surgery symptoms.
For too many, complications from the surgery create even worse problems.
The folks at Dartmouth may or may not be right about the savings to health care in America.
But they are dead on the money on the primary argument - there is far too much art to medicine and not nearly enough science.
Medical practitioners need to be accountable for the results of the care they deliver.
The real savings will be in human lives and human suffering.
The dollars will surely follow.
Of course money is wasted...
With the US spending 16-17% of GDP on health and getting health care that is roughly equivalent to nations that are spending 10-11% of their GDP, there is obviously considerable waste in the US system. Certainly it is an unrealistic argument that these other countries are rationing by up to 70% to get their efficiencies.
However, the problem is in identifying these inefficiencies, but the good news is that now insurers will be unable to deny coverage on preexisting conditions and will be unable place limits on policy costs, they have effectively been 'recruited' to seek out some of these inefficiencies. The question is just how eager they will be to find these inefficiencies based on the changing health care market.