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The Dartmouth Atlas Project
By Laura Knoy on Sunday, August 16, 2009.
The Dartmouth Atlas Project has been quoted by the left and the right during our national health care debate. The Project explores how medical costs and health outcomes vary widely across the country. Researchers say more access to care and more spending often do not mean healthier populations; in fact, sometimes the more health care you get, the worse off you are. We’ll look at health care spending, health care results and how this report could affect the health care debate.
Guests
- Dr. James N. Weinstein, director of The Dartmouth Institute for Health Policy and Clinical Practice, Chairman of Orthopedics at Dartmouth-Hitchcock Medical Center, and practicing spine surgeon at DHMC
- Dr. David C. Goodman, Director of the Center for Health Policy Research at The Dartmouth Institute for Health Policy and Clinical Practice and practicing pediatrician at DHMC
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How is the Study addressing the rising costs,
Are the the costs regionally or nationally driven? Ultimately I beleive that the Insurance companies are controlling and driving up costs,
For example, In 2007,
*U.S. health care spending was about $7,421 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries.
*Total health care expenditures grew at an annual rate of 6.1 percent in 2007, a slower rate than recent years, yet still outpacing inflation and the growth in national income. Absent reform, there is general agreement that health costs are likely to continue to rise in the foreseeable future.
*Government programs, such as Medicare and Medicaid, account for a significant share of health care spending.
* Public health expenditures made up about 46% of the health care dollar in 2007, with the remainder split between private and out-of-pocket spending (42% and 12%, respectively). *Medicare spending has grown at a slightly lower rate, on average, than private health insurance spending, at about 9.0 vs. 10.1% annually respectively between 1970 and 2003.
*Medicaid expenditures, similarly, have grown at slower rate than private spending, though the current economic recession is likely to increase the number of enrollees in Medicaid and therefore increase Medicaid spending.
Inherent in health care reform is an admission (and acceptance) that cost controls mean that insurers, doctors, hospitals, drug companies and medical device companies will make less money. We talk about waste and inefficiency, but every "wasted" dollar is pocketed by some person or corporation, who counts it as income and profit. For patients the current system is bloated, but for providers the system is lucrative.
If we are going to cut the 16% (heading toward 20%) of GDP that we spend on health care, then we have to cut the revenues going to the health care industry. We have to cut doctors' salaries (especially specialists). We have to pay less for prescriptions. We have to buy fewer MRI systems. We have to pay less for hospitalization. I know these things seems obvious, but I hear very little discussion of it. The economic realities explain why the health care industry is almost unanimously allied against reform. No one likes to have their cash flow cut...