Wednesday, January 26, 2011

Dr.Buz Cooper's continuing battle with the Dartmouth Atlas dogma

I have written about Dr. Buz Cooper before ( see here).Very well worth reading is his latest salvo that further strengthens his position that the reason for geographical variation in health care cost is poverty.Here he reviews the latest MEDPAC data.

I think he is saying in part that the "problem" isn't some mysterious regional variation in how doctor practice medicine ( i.e greed seems to distributed geographically by some as yet undiscovered mechanism); the problem is it costs more to care for poor sick patients. Changing doctor's practice patterns won't fix poverty. Somehow, I think electronic medical records (EMRs) won't either.

Here is his nutshell paragraph:

"MedPAC, the IOM and countless other organizations are on a quest to explain geographic variation in health care. Yet the puzzle has been solved, and it is solved again here. Geographic variation in health care is a manifestation of geographic variation in poverty. The logic is obvious to all of us in our every day experiences. Poverty is associated with more disease, and poor people cope with disease more poorly. And poverty is geographic. So it should not be surprising that health care utilization and spending are geographic."

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