Unbiased Analysis of Today's Healthcare Issues

Health care cost rising by almost 10%

Many times I have been asked whether the Affordable Care Act is a good thing.  The 1 sentence answer is: “Yes, because it expands health insurance coverage to more Americans, but no because it adds many layers of regulation and does little to slow cost growth.”  This last point is rearing its ugly head.  Sally Pipes […]

Read the rest of this entry »

Does Increased Hospital Spending Reduce Mortality?

According to Romley, Jena and Goldman (2011), the answer is yes. For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999 to 2003, for example, patients admitted with acute myocardial infarction to […]

Read the rest of this entry »

Why is end-of-life spending so high?

The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use […]

Read the rest of this entry »

Technology’s effect of survival rates and health care spending

How do new technologies affect longevity and health care cost? A working paper by Chandra and Skinner investigates just this question. The authors categorize medical innovations into three broad categories. Category I. These are the home run treatments. The treatments are highly cost effective for all patients with the disease. For instance, the development of […]

Read the rest of this entry »

Is International Healthcare Spending Converging?

It is a well known fact that the U.S. spends more on health care per person than any other country.  But maybe healthcare spending is converging between countries? At least for the years 2000-2008, there is mixed evidence.  U.S. healthcare spending per person grew by 3.4%.  This is slower than Spain (4.7%), the U.K. (4.6%), the […]

Read the rest of this entry »

Is Medicare cost growth slowing?

Ezra Klein reports that this may in fact be the case according to S&P Healthcare Economics. “This chart shows per-patient Medicare revenue falling to a 2.5 percent growth rate, the lowest since S&P Indices started tracking numbers six years ago. At the very top of the this chart you see the ‘commercial index’ — which […]

Read the rest of this entry »

Share of Federal Budget Spent on Health Care Jumped in 2009

In 2008, 38 percent of the federal government’s revenue was spent on health care.  In 2009, however, this figure jumped to 54 percent of total revenues.  Although federal health spending only increased by 17.9%, a decline in revenues of a similar magnitude caused this large change.  Surprisingly, state and local spending on healthcare barely budged.  In […]

Read the rest of this entry »

Regional Differences in Medicare Spending and Health Status

Previous research by the team at Dartmouth Atlas found that there is significant regional variation in spending and disease diagnosis frequency, but this variation is not correlated with higher quality.  However, regional variation may be overstated.  According to Zuckerman et al. (2010): “Unadjusted Medicare spending per beneficiary was 52% higher in geographic regions in the […]

Read the rest of this entry »

Is there really large differences in Medicare Spending across states?

Research by the Dartmouth Atlas team has indicated that Medicare spending is concentrated regionally.  States such as Florida spend much more per beneficiary than do doctors who treat similar patients in low cost states like Minnesota. A recent paper by Reschovsky and co-authors, however, has determined that variation in supply-induced demand is not a major driver […]

Read the rest of this entry »

Health Care Spending Distribution in 2008

National Health Expenditures reached $2.3 trillion, or $7,681 per person. This means that health care services made up 16.2% of the economy. Where did these dollars go? The CBO summarizes where America spends these funds. Source: CBO Long Term Budget Outlook, June 2010.

Read the rest of this entry »