[ExI] Another thread in the healthcare debate

Tom Nowell nebathenemi at yahoo.co.uk
Wed Sep 24 21:56:22 UTC 2008

OK, we've been discussing many things about healthcare and different models. However, I checked the latest issue of UK magazine New Scientist, and it quoted a study by Dartmouth Medical School (Annals of Internal medicine, vol 138 p288) which says that for Medicare spending on hip fracture, colorectal cancer and heart attacks, for every 10% of additional medicare spending in an area, death rates over five years went up by between 0.3 and 1.2 per cent. New Scientist haven't made this article available online, but the original paper is at


I also checked Dartmouth Medical School's website, and in april 07 news

it says that chronically ill patients more money spent on them but lower quality care than the "gold standard" provided by the Mayo clinic. This article mentions that regions that use more services per patient do not have higher quality care. It also mentions the Dartmouth Atlas Project,
which maps out healthcare spending in the US. You can download a 184 page report, or the 20 page executive summary, and there are apparently interactive tools you can use (I know that will appeal to some on this list). 
 So, if an Ivy League medical school is showing that there are huge variations in medicare spending which seems to have little correlation with outcomes, clearly something in medicare needs reforming. The report recommends increasing research into the effectiveness of many forms of health care, to improve national standards and avoid wastage. It also states that hospital providers will want to see their revenues drop, so reducing overtreatment in areas where it is common will be difficult. Hopefully by encouraging better research and better information to patients, overuse of hospital resources can be discouraged.

I'll probably write further when I have time to do more reading than a quick skim of the executive report. No doubt some of our fellow extropians will be able to dig out some interesting facts from the available data.



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