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US: Medicare: more care is not necessarily better care

Phyllis Gardner writes: "This is an extremely important analysis from a Dartmouth medical professor that documents the lack of correlation between per capita Medicare costs and outcomes and satisfaction. It is very important information in my opinion.

No one in Washington is completely satisfied with the Medicare legislation that Congress approved last week. For many conservatives, the shift toward private health plans is too limited; for many liberals, the new prescription-drug benefit is too stingy. Yet almost everyone agrees that the current bill worsens the program's long-term financial stability.Constructive debate about Medicare's costs, however, is hampered by a flawed assumption that both helps and is reinforced by the health care industry: that more care, and more expensive care, is better care.

Earlier this year five colleagues and I published a study of regional variations in Medicare spending. In 2000, for example, per capita Medicare spending was $10,550 in Manhattan, but only $4,823 in Portland, Ore. Despite such a disparity, we found that neither the quality of care nor patients' satisfaction with it was related to costs".

Ronald Hilton - 12.01.03