Higher Spending, Not Better Health

Not only doesn't higher health care spending result in better health, it sometimes makes things worse.

A new study in Pennsylvania evaluating state hospitals that perform heart bypass surgery found those charging $100,000 for the operation had no better death rates than hospitals that charged one-fifth as much, according to today's New York Times.

Meanwhile, a New England Journal of Medicine perspective warns oncologists against overprescribing erythropoietin-stimulating agents. Recent studies have shown that trying to normalize red blood cell counts using Amgen's Aranesp or J&J's Procrit may actually make some cancers worse, and leads to strokes and blood clots. The FDA in March issued a black box warning on the drugs, and cautioned physicians against raising red blood cell counts above 90 percent of normal.

Given the massive advertising behind the drugs and the huge profits that doctors earn from administering them in their offices, "medical oncologists should begin using these agents in a compassionate but disciplined fashion, placing patient benefit above all other considerations," Emory University hematologist Fadlo R. Khuri wrote.