By: Alan Fein, MD, MPH

Alan Fein, MD, MPH — Mon, 16 Nov 2009 16:58:44 +0000

Kudos to Dr Cooper .. while the Dartmouth Atlas and the team that created it have raised the public awareness regarding regional differences in medical practices, payments and utilization, their train has jumped the track in recent years. Their articles in the past year in Health Affairs betray their ivory tower roots. Hanover is a lovely little town but perhaps it is too far removed from the grinding poverty of inner cities. The cost savings from Medicaid and Medicare about which Orszag waxes eloquently are dangerous pipe-dreams. On the other hand, there are huge savings to be had by simply extending coverage to everyone. Taxpayers currently subsidize the poor through cost shifting, with for-profit insurers taking an increasingly larger bite for themselves and granting their executives unbelievable payments [witness the more than $1 billion retirement package given to the last CEO of United HealthCare]. There are enormous efficiencies to be achieved in healthcare by covering everyone, and creating a large enough workforce to meet the needs. I agree with Dr Cooper that we do indeed have too few physicians [and nurses], and heartily disagree with the healthcare economists like Reinhardt and Ginsburg who proclaim that the problem is too many physicians. Keep up the good work Dr Cooper!

Comments on: AHA report disputes geographic healthcare spending theory

By: Alan Fein, MD, MPH