The costs of urban hospitals could put a stick in the wheel of Obama’s overhaul.
The debate over health care overhaul has lawmakers in Washington D.C. considering a question that has plagued the medical industry for some time: just how much money does a hospital need to care for patients?
Congress is hoping to gain a better understanding of why there is a noticeable discrepancy between the spending at rural hospitals in states such as Iowa and Minnesota and the fees incurred by the government at urban hospitals in states such as New York and California.
A doctor at New York-Presbyterian Hospital might attribute the difference to the fact that New York is home to many teaching hospitals that receive a higher-than-average number of patients with complex illnesses that are more costly to treat. But a surgeon at Iowa Lutheran Hospital in Des Moines might simply chalk up the difference to big city hospital inefficiency.
A provision in the Affordable Health Care for America Act, which barely passed in the House on Saturday, orders a two-year study by a neutral group, the Institute of Medicine, to investigate regional variations in Medicare spending. The plan’s supporters cite a 2005 Dartmouth Medical School study, which claims that by making hospitals more efficient, Medicare could save $1.42 trillion over 14 years.
The study found that patients in hospitals who spend more do not show significantly better health results.
Going by the Dartmouth research, it seems employing the IOM would be unnecessary.Congress should cut Medicare funds for the biggest spenders and give the money to the lowest spenders.
Unless, of course, the Dartmouth study was wrong, which is exactly what researchers from six California medical centers maintain. Their work showed that the mortality rates between the highest- and lowest-spending hospitals varied by as much as 50 percent.
The California study is a godsend for big hospitals and a nightmare for basically everyone who is sick, poor or a taxpayer. It lends credence to the idea that throwing enough money at a health problem can solve it.
Virtually everyone can agree that medical costs are out of control. The claim of medical officials in urban areas that their populations have higher costs of living and are more prone to poverty and are therefore less healthy is a valid argument.
But everyone’s costs are too high, not just those of poor people in big cities. Whatever rural hospitals are doing that allows them to charge the government less money than urban hospitals needs to be made the standard nationwide.
Unfortunately, doctors have made it clear that they are not going to self-regulate their charges to Uncle Sam. They have left the government little choice but to conduct this study and enforce some money-saving changes.
Taxpayers can only hope and pray that the research turns up some practical methods of small-town hospitals for the rest of the country to emulate.
Jared Luck is a communication senior and may be reached at [email protected]
