In the first of a three-part series on health care costs in America, NPR’s Alix Spiegel tells the story of the birth of the Dartmouth Atlas, how some of its founder’s earliest research changed the health care delivery system in Maine and what it tells us about health and money. Spiegel unspools the story as a series of questions, the answer to each of which pushed researchers and physicians closer to an understanding of what drives health care costs in America.
The story kicks off in the mid ’60s when John Wennberg, now famous (among health reporters, at least) as the father of the Dartmouth Atlas, got a grant to study the best way to expand health technology to rural Vermont. To answer that question, Wennberg asked what health care was actually delivered in the state. From there, he discovers massive geographical differences in the frequency of procedures such as hysterectomies, and the questions and answers tumble neatly into line like so many dominoes.
Part two of the series, focusing on how active patient participation drives up costs, will air next week on NPR’s Morning Edition. In the third installment, Spiegel will examine the cost impact of direct-to-consumer advertising of prescription drugs.