Levels Versus Growth Rates
[I]t is well established that some regions spend considerably more than others in the Medicare program without delivering higher-quality care or generating greater patient satisfaction.
Yet low spending is not the same as low spending growth, and even efficient areas can experience considerable spending growth. In fact, many areas that had low spending in 1992 did not have notably lower spending growth between 1992 and 2006 than other areas… Rochester, Minnesota, and Salt Lake City, for instance, are known for high-quality, integrated providers and have low Medicare spending per beneficiary. Yet between 1992 and 2006, inflation-adjusted Medicare spending per beneficiary rose 4.3% annually in Salt Lake City and 3.8% annually in Rochester, as compared with 3.2% for the country as a whole. In short, areas with exemplary delivery systems do not necessarily have exemplary rates of spending growth.
From a study Joe Newhouse and his colleagues in the New England Journal of Medicine (gated, but with abstract).
Good point, aand one often ignored in these discussions.
This same point applies to international comparisons as well. Although th US has a higher level of spending, the growth rate of real per capita health spending in the US is right below the OECD average. Basically, all the deveoped countries are taveling up the same unsustainable path at basically the same rate.
That a point people often do not consider when they tout Mayo, Cleveland clinic and Intermountain Health care as models for the problem of runaway health spending. These facilities are efficient; but they still are on the same growth path as the inefficient hospitals. The same is true to managed care. The savings represents a one-time reduction in cost but not a bending of the cost curve.
Good point.