Blue Dogs Stick it to Urban Centers
The Blue Dogs had a couple of conditions for signing on to the health care bill. The big one, you probably remember, was convincing House Speaker Nancy Pelosi that public option rates should not be tied to Medicare. But there’s another, less-covered piece that Blue Dogs wanted. The measure would create the Institute of Health to put together recommendations for reducing costs in areas with high Medicare spending. It would also reward places where costs are lowest.
Blue Dogger Dave Loebsack (D-Iowa) said in a statement that “this agreement rewards states like Iowa who have put patients and their care first.” The loser will be urban hospitals, which are usually in districts of more liberal representatives.
As you can imagine, this isn’t sitting well with health executives in places like New York, who argue that their services cost more because they are serving a poorer population with a greater range of health care risks. “Unless we deal with the problems of poverty in underserved areas, health care will be expensive in urban areas,” Dr. Kenneth L. Davis, chief executive at Mount Sinai Medical Center in New York, told the New York Times.
Many more rural districts treat less people and slightly more affluent populations, which New Yorkers say accounts for the differences in spending. Another words, this measure helps places where Blue Dogs hail from, like the west and midwest.
This idea isn’t in the Senate bill, and it’s unclear whether it will be added to the final legislation. But it’s definitely something to watch.
Good catch… this one will be interesting. I’m all for a big-tent… sure beats the ideological purity tests the GOP constantly runs on its members these days, but falling into the GOP trap of slicing and dicing America is ****. The urban centers are just as much America as the small towns. I’m tired of a representation otherwise…
The provision would not create an “Institute of Health” but direct the Institute of Medicine, part of the National Academies, to conduct the study and fast track the results to legislation. This is not uncommon in health financing legislation.
This work is already going on although perhaps not within the IOM’s purview; it falls under best practices. After all, since it has been demonstrated that the low cost areas have outcomes that are as good as or even better than the outcomes in high cost areas, then it follows that the systems and practices are at least likely to be somewhat better.
However only a superficial reading of the data could lead one to think that it is an “urban vs rural” or even poverty vs better off people.
Those are excuses. While it is true that social inequality and racism are critical drivers of health status it is undeniable that low quality care and overtreatment are the biggest cost drivers.
Cleveland Clinic is in an urban environment and provides excellent care at a low cost. McAllen Texas has outstandingly high cost care in a non urban district with comparable demographics to El Paso, an urban area costing less than half the McAllen tally.
Keep in mind that while ~ 45,000 people die each year in the US from lack of access to care, ~ 198,000 die each year from PREVENTABLE medical errors in hospitals alone. Less sloppy treatment will save lives as well as the costs of attempted mitigation of the errors.
SuiGeneris - What is your source for the 45,000 and 198,000 figures?