Miami Herald Examines High Health Care Costs in South Florida
People in South Florida "use a lot more health care, at a much higher cost, than perhaps anywhere else in the United States," the Miami Herald reports. Although health spending has traditionally been high in Miami, experts have recently reexamined the situation because "soaring medical costs are causing the numbers of uninsured to soar and are threatening to impoverish Medicare just as the baby boomers need it most," the Herald reports. Medicare per beneficiary spending in Miami is twice as high as Medicare per beneficiary spending in Minneapolis, without "any benefit, either in life expectancy or quality of care," Megan Cooper, editor of the Dartmouth Atlas of Healthcare, said. According to a Dartmouth College study of 1996 data, the average spending per Medicare beneficiary who was not enrolled in an HMO was $6,109 in the Fort Lauderdale area and $7,783 in Miami, compared with $3,700 in Minneapolis and $4,993 nationwide. Roger Feldman, a University of Minnesota health expert, said that the Minneapolis area has been able to control health spending because many Medicare beneficiaries there are enrolled in HMOs and the area has many large multispecialty provider groups, which can coordinate care and keep costs down. In contrast, many Miami doctors practice alone or in small groups, which can lead to "uncoordinated care," Feldman said. Miami and Fort Lauderdale have about 20% more specialists than the national average, and in Miami, "physicians are much more likely to refer to other specialists," Dartmouth researcher Elliott Fisher said. Bruce Shanefield of Aon Consulting's Miami office said, "We tend to over-utilize [in Miami]. The number of times we go to the doctor, and diagnostic services -- it's kind of unique. We tend to over-utilize the ER, and when that happens, there's a good chance someone will spend a night or two in the hospital." Len Nichols of the Center for Studying Health System Change, added, "[I]n the Greater Miami area, you do have this concentration of retirees, and they talk to each other. It's kind of a culture, checking out what a neighbor's doctor did for some malady." Costs may also be high because some physicians practice defensive medicine, or perform unnecessary tests and procedures to avoid lawsuits, according to Terry Smith, chief medical officer for Humana (Dorschner, Miami Herald, 7/21).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.