Jo Hunter Adams
A recent New Yorker article by Atul Gawande tells the story of the town with the highest health care costs, set against the Mayo clinic. Two things are striking:
1) The best care-- the care with the best health outcomes-- is not the most expensive care.
2) The care a doctor provided depended a lot on their medical training and their personal beliefs about medicine.
Here are some excerpts:
"Two economists working at Dartmouth, Katherine Baicker and Amitabh Chandra, found that the more money Medicare spent per person in a given state the lower that state’s quality ranking tended to be. In fact, the four states with the highest levels of spending—Louisiana, Texas, California, and Florida—were near the bottom of the national rankings on the quality of patient care."
"Fisher found that patients in high-cost areas were actually less likely to receive low-cost preventive services, such as flu and pneumonia vaccines, faced longer waits at doctor and emergency-room visits, and were less likely to have a primary-care physician. They got more of the stuff that cost more, but not more of what they needed."