This rebuts the idea that healthcare costs have to rise, says Stephen Black

It is a widely held belief that the cost of healthcare must continue to rise because people are getting older, technology is being developed for better diagnosis and treatment and people are living less healthily. Although the examples and data in Overtreated are from the US, it offers a powerful rebuttal to that myth.

Much of the book is spent discussing particular examples and the reasons why much of US medicine is broken. But the story of Jack Wennberg and the team that created the Dartmouth Atlas of Health Care is of particular note.

By analysing patterns of medical spending, activity and illness across regions of the US, the Dartmouth team demonstrated that more healthcare is often the enemy of better healthcare. Activity was unrelated to need, but is explained by the availability of doctors and beds. The providers - not the patients - were driving activity and cost. Brownlee illuminates the dry statistics of the Dartmouth analysis with stories of real patients, making the book easier to read but tending to get in the way of the numbers.

The book’s focus on the US is its biggest drawback for UK readers, but there is evidence that the NHS makes some of the same mistakes, if for different reasons. So the questions posed are still valuable even here. Maybe we need a British Dartmouth Atlas.

 

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