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Dartmouth Study Is Based On Untested Theory

June 11, 2009 (LPAC)—The Dartmouth Atlas Project (better known as the Dartmouth Study), used repeatedly by President Obama's henchman, Peter Orszag, to push through a Nazi health care system in this country, was derived directly from the Tony Blair-created NICE's proposal to cut health care costs in the British Isles by evening out disparities in medical costs between different postal zones. In the United States, some senior physicians have picked up the cudgel against the Dartmouth Study, which claims 30% of health care costs in this country are ineffective and this ineffectiveness can be eliminated by narrowing these local variations by bringing costs down from high-spending regions to low-spending regions, by pointing out: "That's a very, very bad number to put faith in. Health care is such a complicated area that it's hard to take any big aggregate number with great certainty."

Tom Rosenthal, MD, the UCLA Medical Center's chief medical officer, said the Medicare claims used by Dartmouth researchers in the 2008 Dartmouth Atlas of Health Care do not capture some unique demographic and workload issues facing higher-spending hospitals. For instance, Dr. Rosenthal said UCLA — one of the highest spending hospitals in the Dartmouth Atlas — has far more patients waiting for heart transplants and requiring costlier care than does the Mayo Clinic in Rochester, Minn. — one of the lowest-spending hospitals. Take the question on whether a negative CT scan of an injured knee is wasteful spending, Dr. Rosenthal said. Lawmakers must ponder whether there is value in a patient feeling better after knowing the results. "Is that waste?"

Research by Dr. Robert A. Berenson, who was a Medicare official in the Clinton administration, and Jack Hadley of the Urban Institute, suggests that much of the geographic variation in health spending can be explained by differences in "individual characteristics, especially patients' underlying health status and a range of socio-economic factors, including income." Dr. Berenson said, "There remains too much uncertainty about the Dartmouth findings to ground public policy on them."


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