POLICY: Overtreated gets huge plaudit

OK. It’s official. David Leonhardt is a convert, even one who can’t quite leave his past behind. In is NY Times selection for Economics book of the year he picks Shannon Brownlee’s Overtreated. (If you want to hear me and Shannon having a good gossip about the American health care system, see here).

Leonhardt can’t quite shake his Stephen Colbert-like past (the market has spoken so it must be true). He still says this:

As I’ve written before, there is nothing wrong with devoting a large chunk of our economy to medical care. Since the 1950s, doctors have made incredible progress against diseases that were once inevitably fatal. That progress is probably the finest human achievement of the last half century. If we weren’t wasting so much money on overtreatment, it would be a lot easier to repeat the achievement over the next half century.

Of course, and it’s been pointed out ad nauseam here, those results were achievable at a much lower cost than we’ve paid, and the difference could have been spent on something with a higher economic return (or in invading any middle eastern countries we haven’t got to yet).

But it’s great to have Leonhardt on board, at least for the Wennberg thesis. Now he just has to convince the rest of the NY Times editorial board.

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4 replies »

  1. I read this book and thought it was VERY thought provoking.
    I would like to see more from the Dartmouth group.
    It was not hard to read, a non-economist could easily get through it. I think the notion that medical supply creates it’s own demand is important to remember.

  2. Right. But a bigger problem is undertreatment. Early interventions are orders of magnitude cheaper than treating advanced disease states, and far more effective. The “too much healthcare” argument is spurious unless you also take into account the lack of access to primary care that Americans suffer relative to our global competitors.
    Check out the Commonwealth Fund’s just-released “Bending the Curve” study, making a case for comprehensive reform and universal coverage:

  3. I read this interview today. Not 1 hour after I finished we had our quarterly town hall for the IS department for a large Catholic Healthcare organization. I figured it might not be a bad idea to bring this up as the CIO does the presentation. The first thing he brought up was the dartmouth studies and the New Haven/Boston comparison. Apparently word is getting out.
    Cross posting to interview and reference to NYT Overtreated link.

  4. Without knowing much about economics, I’ve always questioned the overall efficiency of a system, in the wealthiest nation on earth, that can’t afford to research diseases if they’re too rare. Yet these “orphan diseases” could really use adoptive parents.
    But as you point out, the odd “preemptive strike” tossed in along with such wise expenditures as our perpetual war on drugs, makes it hard to find the cash for such trivial matters. Besides, if we just get tough enough for long enough on those “narco countries” and all other bad guys, we’re sure to turn the tide, the total lack of evidence notwithstanding. (Def., “narco country:” NOT the biggest consumer country of illegal drugs.)