I know that many HealthBeat readers don’t have time to peruse all of the comments.
So I thought I would post two comments on “The Attack on the Dartmouth Research” that caught my eye:
“One of the most interesting aspects of the Dartmouth data is the comparison of centers located and working in the same city or area.
Dartmouth data demonstrate that centers like Mayo Clinic Scottsdale, Kaiser Bay Area, Group Health of Puget Sound, Geisinger Clinic, and many others outperform — cost less and have better results — than other centers in the same exact city or market. This negates all arguments that differences are due to regional, ethnic, economic, and other factors (including malpractice environment) and illustrates conclusively that the differences are due to practice patterns.
I do expect a lot more push back on this in the future however, for two reasons.
First it runs directly into the ego and reputation of many prestigious medical systems and supposedly sophisticated geographic areas of practice. The idea that people in small cities in the West and Midwest are doing a better job than silk stocking medical care in large cities on the coasts and in the Sunbelt is very threatening.
Second, it remains a truism that one person's medical waste is another person's new beach house.”
Posted by: Pat S
“Throughout this past summer I've found it frustrating that so much of what reformers have been forced to do is refute outlandish silliness. Cooper's assertions are the high-brow version of Palin's "Death Panels."
The strategy clearly is to obfuscate on all possible levels, forcing reform voices perpetually to play defense until the country tires of the noise, wishes a plague on both sides, and refuses to consider any change at all. Victory then goes to the unsustainable status quo. Very shrewd. And also very immoral.”
Posted by: Chris Johnson
The best rebuttal form the Dartmouth atlas group iin NEJM today at
http://content.nejm.org/cgi/content/full/361/13/1227
Maggie – I’d add that the majority of Americans want the problem fixed, and it is a small, albeit highly vocal, minority that doesn’t. Many are relatively ignorant, susceptible to fear mongering, and all too eager to accept at face value what some idiot on Fox or talk radio spouts.
But remember, they are a small minority.
Joe Paduda
Matt and Joe–
Matt– Thanks very much for the head’s up.
It’s an excellent artice. The DArmtouth foks told me about it and I received an early copy online because I subscribe to the journal online. I’m planning on using it in part 2.
Joe-
Very good to hear form you.
I agree that a vocal minority is opposed to, and spreading the fear about health care reform.
My only concern is that the quieter majority is confused about what healthcare reform would mean.
It seems to me that the media has done a much better job of covering the vocal minority –rather than covering what is actually in the heatlh reform legislation..
Of course the legislation is much drier stuff-and not s likely to sell newspapers.
But this is what the public needs to know