An analysis in the New England Journal of Medicine finds that an influential study on which President Obama’s health care plans are based is flawed:
For much of the past year, President Obama lavished praise on a few select hospitals like the Mayo Clinic for delivering high-quality care at low costs, but a pointed analysis published Wednesday in an influential medical journal suggests that the president’s praise may be unwarranted.
Mr. Obama received his information about the hospitals from a widely cited analysis called the Dartmouth Atlas of Health Care, produced by the Dartmouth Institute for Health Policy and Clinical Practice. An article in The New Yorker magazine last year written by Dr. Atul Gawande that used the Dartmouth Atlas as its organizing principle became required reading in the White House last year.
But an analysis written in The New England Journal of Medicine by Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center in Manhattan, suggests that much of the Dartmouth Atlas is flawed and that it should not be used to compare the relative efficiency of hospitals.
The analysis identified more than one flaw in the Dartmouth study, but most important one is that the study looked only at dead people. It grades hospitals on their efficiency based on how much money they spent on people who died, without considering the possibility that fewer people might have died with better care:
Say Hospital A and Hospital B each has a group of patients with a fatal disease. Hospital A gives each patient a $1 pill and cures half of them; Hospital B provides no treatment. An Atlas analysis would conclude that Hospital B was more efficient, since it spent less per decedent. But all the patients die at Hospital B, whereas only half of the patients do at Hospital A, where the cost per life saved is a bargain at $2.
This underlines the fundamental problem with government-run health care everywhere it’s been tried: they save money by reducing the quality of care.
(Via Instapundit.)
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