Minor Thoughts from me to you

Rethinking Centers of Excellence (and Other Well-Laid Plans)

Rethinking Centers of Excellence (and Other Well-Laid Plans) →

Dr. Pauline Chen, writing at the New York Times.

The researchers then compared these outcomes to those of patients who were not covered by Medicare and therefore not restricted to having their operations done at centers of excellence. Even after adjusting for individual patient risk factors and the specific type of bariatric procedure performed, they found no differences in complication rates or outcomes between Medicare and non-Medicare patients. Moreover, they discovered that many of the improvements had been under way prior to 2006.

In other words, the much-heralded policy of funneling patients to centers of excellence has had little effect on how patients do.

Over the past several years, I've seen lots of people talking about how this or that government program fixed this or that problem in the United States. And, almost invariably, I'll see economists pointing out that the trend line was already declining before the government got involved and that the government's involvement did nothing to speed up the change.

Without this research, this Medicare policy would have received the same praise even though it, too, deserves none of the credit.