A triumph for evidence-based medicine in Green Bay:
In the final two years of a patient’s life, for example, they found that Medicare spent an average of $46,412 per beneficiary nationwide, with the typical patient spending 19.6 days in the hospital, including 5.1 in the intensive-care unit. Green Bay patients cost $33,334 with 14.1 days in the hospital and just 2.1 days in the ICU, while in Miami and Los Angeles, the average cost of care exceeded $71,000, and total hospitalization was about 28 days with 12 in the ICU.
Some differences can be explained by big-city prices, acknowledged Elliott Fisher, principal investigator for the Dartmouth Atlas Project, “but the differences that are really important are due to the differences in utilization rates.”
Much of the evidence suggests that the more doctors, more drugs, more tests and more therapies given to patients, the worse they fare — and the unhappier they become, said Donald Berwick, president of the independent research group Institute of Quality Improvement.
One lesson: numbers matter. Tired N=1 arguments and “personal stories” don’t get to overall health, no matter how tragic and unfair they are (and I’m looking at you here, Michael Moore). What is tragic and unfair is an overall system in which people who become ill through no fault of their own use emergency rooms as primary care facilities, which paradoxically adds to the cost burden of people who do not want to pay for comprehensive health services. Indirect costs can easily exceed the modicum of investment that such a plan would require.
I’m not sure why people who cry “socialism” at the thought of ensuring a basic level of health in the most powerful nation in the world seem not to be bothered by a “socialist” education system that attempts the same for education. Perhaps the message would be more palatable if stated in economic or national security advantages.
So, good for Green Bay.