New data fuels some regional disputes on Medicare spending while some communities create better care and spend less than others. The New York Times
reports that "new government data show that Medicare costs per patient in those cities [New York City, Boston] are slightly below the national average when the numbers are adjusted for the cost of living and other factors. The new numbers add fuel to a raging debate over what Congress should do to reduce geographic disparities in Medicare spending. The debate involves a combustible mix of health policy and money."
As part of efforts to to revamp the health care system, "President Obama and Democratic leaders in Congress say they want to reward doctors and hospitals for providing higher-quality, lower-cost care. But their efforts have touched off a fight within the Democratic Party, pitting urban lawmakers against rural lawmakers and creating a major new hurdle for health legislation. Mr. Obama says the nation could save huge sums if all doctors and hospitals were as efficient as those in lower-cost states like Iowa, Minnesota, Washington and Wisconsin. Lawmakers from those states have reached an agreement with House Democratic leaders that would increase federal Medicare payments to health providers in their states. Higher-cost states, which could see their Medicare payments reduced, are fighting back" (Pear, 9/7).
Meanwhile, the Associated Press
reports on communities and health systems that spend less money and offer better quality care using innovative approaches: "'Does the public buy the idea that more care is not better? The answer is no. Yet you're doing it,' Dr. Donald Berwick of the nonprofit Institute for Healthcare Improvement told a recent meeting of La Crosse and nine other communities that spend about $1,500 less per Medicare patient than the national average but rank well for quality" (Neergaard, 9/8).