Indeed.

Never let it be said that the scientists who publish in dry, staid medical journals lack a sense of humor. That resurrecting dead patients line is the title of an article that appeared in JAMA [Journal of the American Medical Association] a few years ago, and beyond the fact that it provided me with a snappy headline, gives me the chance to post one of my favorite lolcats [again], and is cited in another article in another journal, it has no further bearing on this post.

The another article in another journal, Looking Forward, Looking Back: Assessing Variations in Hospital Resource Use and Outcomes for Elderly Patients With Heart Failure, is monumentally less gripping than, oh, the last installment of Harry Potter, or even the labels on cat food cans, but it's nonetheless an important data point in the present health care deform reform debate.

To back up for just a moment, the Dartmouth Atlas Project is a massive gathering of data gleaned from Medicare spending records over many years. Mapping the data has produced the realization that Medicare spending varies widely throughout the country. Peter Orszag, President Obama, and Tom Harkin, to name just a few personages, are all quite taken with it, and with the Dartmouth researchers' assertions that the patients in higher-spending regions fare no better than those in lower-spending regions.

If only those spendthrifts in Miami and McAllen could be made to behave more like those prudent paragons living in Minnesota, we could save hundreds of billions of $$$$$ in health care spending every year.

Not so fast, corpus breath. The Dartmouth Atlas only catalogs dead people. The researchers looked back over the patients' lives for the 6 months [and for some purposes, 2 years] before they died. Concluding that since they all died anyway [duh!], the ones who got more care [and therefore cost more money], didn't really need all that extra care [and therefore we don't need to be spending that extra money on them].

It's an attractive notion, but one of the things the Dartmouth researchers didn't do so much of was looking forward.

Based on Matt Taibbi's post (Thanks BDBlue!), I thought it would be good to bring up some history. You know, there was at one time this thing people would do, called "protest", and occasionally it had results (however meager and fleeting they might be). But results nonetheless:

Every health deform care wonk will tell you that unless we remake the US into one giant network of Mayo Clinics, we'll never get health care spending down to a reasonable level.

Meanwhile, although the original Mayo Clinic in Rochester MN and the satellite Mayo in Jacksonville FL haven't said anything, at least one Mayo in Arizona is opting out.

From the Star Tribune:

"One victim used to sell health insurance.

Another is a retired deputy attorney general.

A third is a 93-year-old woman from West St. Paul.

All three were tricked into buying what they thought were health insurance policies that turned out to be empty promises, according to two lawsuits filed Wednesday by Minnesota Attorney General Lori Swanson.

Swanson accused two out-of-state companies, Consumer Health Benefits Association and Home Health America LLC, of "scamming Minnesotans citizens."

Long, and very wonkish, answer here. It's a nice primer, quite readable, and well worth your time.

The longer answer is more complex than just yes-or-no, because modern health care, even in the best of worlds, is complex. While I think that Medicare's labyrinthine payment system has just added to this problem, that's a subject for another day.

Meanwhile, the last two sections of the post make a nice summary:

And Another Thing...

One other consideration deserves attention.
Hospitals base their cost calculations on spreading the costs of various operating expenses evenly over all patients. However, there is at least one important area where Medicare patients actually cost hospitals considerably less than private insurance patients: the cost of billing for services.

Study after study shows that it costs hospitals 50% to 75% less to bill Medicare than to bill private insurers. In fact, for the mythical “average” hospital, the loss from Medicare of 3% to 7% may actually be cancelled out by the lower costs of billing. This is an area of hospital management where costs are actually being shifted from private insurance to Medicare, rather than the classic opposite.

[Do read the comments. --lambert]