Underuse is Rampant, But Overuse is All We Talk About

By KIP SUILLIVAN, JD This is my fourth in a series of imaginary lectures on remedial health policy for President Obama. My goal is to convince Obama that he relied on the wrong people for health policy advice. I am focusing on three people in particular: Elliott Fisher and his colleagues at the Dartmouth Institute, Peter Orszag, and Atul Gawande. In my first comment , I criticized Obama for clinging to the belief that the Affordable Care Act has already reduced health care inflation and will continue to do so in the future. I devoted my second comment  to explaining how influential the Dartmouth Institute has been. In my last comment I set forth the reasons why the Dartmouth group’s influence has declined since approximately 2010.  I devote this comment to a review of some of the evidence that indicates underuse (the failure of the health care system to deliver necessary care) is more prevalent than overuse. Knowing that fact is useful not just for understanding my criticism of Obama but for understanding how flimsy the justification is for accountable care organizations and other managed care nostrums. I have only enough space here to introduce you to the best of the under- and overuse literature. I believe it will be enough to convince you that underuse is more common than overuse. Once you comprehend that fact, you’ll also comprehend that it is neither logical or ethical to base health policy on the assumption that overuse is the only form of inappropriate use we mus...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs