Yesterday’s NYT article questioning the validity of the Dartmouth health spending disparities research has received a good deal of backlash and reiterated my initial reaction that the paper was looking to stir controversy rather than conduct a serious dissection of the Dartmouth analysis.
The Dartmouth researchers have released their own document debunking some of the falsehoods in the NYT piece– for instance, several of the maps do reflect quality of care and they have presented risk-adjusted measures of spending for chronically ill patients — and over at the Health Beat blog, Maggie Mahar tracked down some of the sources in NYT story who claim that their quotes were taken out of context:
- DAVID CUTLER: “Every word is clearly accurate, but the implication is wrong.”
- DR. HOWARD KRUMLORTZ: “What I spent most of the interview trying to convey is that a lot of the back and forth [about bits and pieces of Dartmouth’s data ] is inside baseball stuff – and we are all working hard to figure out how to gauge costs and value better .But Dartmouth’s work on variation is pivotal to moving us forward – and we all agree that there is lots of waste and it is unevenly distributed across the country. ”
- UNNAMED SOURCE WHO SPOKE WITH NYT: “Harris and Abelson were determined to write a story that would ‘take down Dartmouth.”
Mahar also points out that the story could present a conflict of interest, since, as the NYT has explained, “Some proposals in Congress call for using the analysis . . . to begin spending less money on regions where medical care is especially costly, including places like New York City.” ”Manhattan hospitals spend generously on ads in the Times, and this puts the paper in an awkward position,” Mahar notes.
The point here isn’t to completely dismiss the article — after all, complex research often invites its share of uncertainly and critique and the NYT is merely doing its part in airing these concerns. But why is the paper running an inside-baseball dispute about health economics on A1 and using gross generalities to gloss over the intricacies and complexities of the Dartmouth maps? Administration officials may have touted their findings, but this story was published months after Congress passed a health care law that appropriated very little from the Dartmouth research! As one source told Mahar, “It sounds as if it were written by someone’s ex-spouse.”
In the aftermath of reform, reporters have been writing sensational stories about how health care reform is not meeting expectations (even though it’s been just two months) while paying far less attention to the difficulties and challenges of effectively implementing the measure on the state level. And I would argue that the latter is far more significant to the future of the nation than a few momentary gocha controversies that do nothing but generate links from conservative bloggers and get your article entered into the Congressional record by Republican Congressmen.