Tuesday, July 14, 2009

Schroeder Critiques Grand Junction Model

Dr. James Schroeder has written a great OpEd for the July 10, 2009 Grand Junction Free Press criticizing the "Grand Junction Model" for health care which is now being touted as the method to achieve government health care reform.

Here's an excerpt from his piece, "Die sooner, save money":
...First, a large study done at Dartmouth University looking at variations in Medicare spending was released in April 2008. More recently Dr. Atul Gawande, an Ivy League surgeon, wondered in the June 1 issue of The New Yorker magazine why McAllen, Texas, had one of the nation's highest levels of Medicare spending. Grand Junction's name came up in that article as one of the lowest spending regions.

Now, President Obama's team is using the Dartmouth study to leverage advancement of the Democrat party's health care proposal.

...All the data showed is that some hospitals spent more than others. As such, this study could serve as a starting point for further research, not as a measure of how to model health care delivery for the nation as a whole. Now let me rephrase this in case you weren't paying attention. The death rate in this particular study was 100 percent. Yes, you read that right, every single patient analyzed in this study died! The only logical conclusion to be made is that Grand Junction is efficient at getting people to the point of death.

Hang on to your wallet, because the Dartmouth Atlas will now be touted as showing that some regions (Grand Junction being the shining example) are “more efficient” at delivering health care while saving money! This in turn will serve as the anvil upon which health care spending throughout the country will be hammered into line by a federally controlled health care system. In fact, the Dartmouth study reveals absolutely nothing about efficiency. Determining "efficiency" will require looking at end points other than death, and will include individual interpretations of value, quality and lifestyle. But those things are much more difficult to measure, so we are about to be treated to an example of using data wrongly to support a wrong-headed argument.

...The current administration advocates a system that will take those difficult value judgments out of your hands and put them in the hands of a nice, caring, compassionate bureaucrat. If one could practice medicine by a cookbook approach, we would not need more family physicians, we would need fewer, because a simple computer program could do the job. But it just is not that simple.
(Read the whole thing.)

Government-run health care can always save money by denying care and taking decision-making out of the hands of doctors and patients and shifting it onto the bureaucrats.

It's "efficient", but deadly.

Is that what Americans want?

(I do have a couple of minor disagreements with Dr. Schroeder's analysis, which are also nicely covered by Ari Armstrong. But overall, I agree with his major points.)