Devil’s in the details

The editorial, “Bedside Manners” (BDN, March 4), arrives at a conclusion, drawn from the majority and minority reports of the recent Commission to Study Maine Hospitals, to the effect that Maine “… clearly can find savings while improving already commendable quality in its hospitals.”

Details are necessarily minimized in most editorials, but there’s where the “devil” appears to reside in this one.

Quoting the editorial, “In brief, the majority report says Maine’s hospitals are more costly than the regional average and much more costly than the national one.” This was said to rely “… on work by Dr. Nancy Kane of the Harvard School of Public Health.”

However, a (commission) minority report “… uses figures from the American Hospital Association to show that Maine hospitals are less expensive than those in New England and only a little more than the national average.” Therefore, said the minority report, Kane’s figures were wrong.

It then tells us the majority and minority reports, nevertheless, did agree on 14 of 20 recommendations for hospital care. The “devil” in this instance is whether the criteria used by the majority were at least roughly comparable to those used by the minority to evaluate cost effectiveness. It’s a lot more complex than that, but it’s a symptom of the problems with a very wide range of health care issues.

How does a layperson know which book is the right one to read?

Robert C. Dick

Castine