Tuesday, November 17, 2009

Health Care Waste or Paying for the Sick Poor?

The verse that follows is based on a November 16 Philadelphia Inquirer report “Health-Care Heresy,” that read, part,

“As he raced through the U.S. Capitol this fall, Dr. Richard “Buz” Cooper, a 73-year-old University of Pennsylvania medical school professor, didn't mince words. He denounced as “malarkey” a reigning premise of the health care debate -- that one-third of the nation's $2.5 trillion in annual health spending is unnecessary -- and said that the idea came from “a bunch of clowns.”

“The harsh language underscores Cooper's disdain for highly regarded work -- as close to a sacred cow as anything in health care -- developed over two decades by the Dartmouth Atlas of Health Care. The work by Dartmouth Medical School researchers shows huge geographic variations in the amount of care that hospitals and doctors provide, with spending in some areas running three times as much as in others. Dartmouth argues much of the high spending is due to extra procedures and tests that often don't help patients, but bring in more money for doctors and hospitals.”

“The argument has been embraced by President Barack Obama's administration and several lawmakers, who have repeatedly said that the nation could save as much as $700 billion a year -- if only doctors and hospitals in high-spending areas, such as Philadelphia, Los Angeles and Chicago, would end their profligate practices and adopt the thriftier ways of say, the Geisinger Health Systems, based in Danville, Pa. The House has inserted provisions in the health bill that could punish high-spending hospitals in Philadelphia and elsewhere, while rewarding low-spending facilities in places such as Albuquerque, N.M., Madison, Wis., or Portland, Ore.”

The Poverty Factor

“But Cooper and some allies say that would be a disaster and hurt efforts by doctors and hospitals to care for the poor. Cooper says the Dartmouth research doesn't take into account the high cost of helping the impoverished, who often spend more time in hospitals because they don't have people to care for them at home and often return to the hospital when they can't afford needed medications. “

“There is abundant evidence that poverty is strongly associated with poor health status, greater per capita spending, more hospital readmissions and poorer outcomes,” he wrote in an Oct. 24 post on his blog. “It is the single strongest factor in variations in health care and the single greatest contributor to 'excess' spending.”

How much of U.S. health spending is waste?
How much of this spending is poverty-based?
The Dartmouth people says unwarranted waste is 30% of health care.
Cooper says caring for the poor is something hospitals have to bear.
Dartmouth says eliminating excessive regional variation,
Will be the American health system’s economic salvation.
Professor Cooper of Penn says this is unadulterated malarkey,
Dartmouth studies are the work of a statistical sharkey.
But who is right and who is wrong,
You can argue that query all day long.
But when you have a sacred cow to gore,
It helps if you do it to protect the poor.

No comments: