A costly paradox: more spending, no better health. - Dr. Elliott Fisher
Dr. Elliott Fisher has spent decades uncovering why high-spending regions fail to deliver better care or longer lives — and what this means for patients and policymakers.
Episode Summary
America spends more on healthcare than any nation on earth — and gets less for it. Dr. Elliott Fisher's decades of research, culminating in the Dartmouth Atlas, proved something the system desperately didn't want to hear: high spending doesn't equal high quality. In this episode, he walks through the original 'Variation Studies' findings, explains why Medicare's biggest spenders deliver worse care, and describes what a high-value system would actually look like. He also tackles the political challenge of changing incentive structures that reward volume over value — and why he remains cautiously optimistic.
People Mentioned
- •Jack Wennberg — Pioneer of healthcare variation research, founder of the Dartmouth Atlas
- •Roger Fisher — Harvard professor, co-founder of the Program on Negotiation
- •Mark McClellan — Former CMS & FDA administrator, key architect of ACOs
- •W. Edwards Deming — Quality management pioneer
- •Martin Wolf — FT chief economics commentator
Books & Resources Mentioned
About the Guest
Dr. Elliott Fisher
Director Emeritus, The Dartmouth Institute for Health Policy & Clinical Practice
Dr. Elliott Fisher is one of the most influential health policy researchers of the past 30 years and creator of the Dartmouth Atlas of Health Care. His landmark studies revealed that Medicare spends twice as much per patient in some regions than others — with no improvement in outcomes, quality, or access. This counterintuitive finding reshaped the national debate on healthcare value and became foundational to the Affordable Care Act's cost-reduction provisions. He is a physician, professor, and Director Emeritus at The Dartmouth Institute.