Abstract
In November of 2007, Health Affairs (2007) selected John Wennberg as the “most influential health policy researcher of the past quartercentury.” The health care reform debate of 2009–2010 confirmed that judgment. The variations literature, in which his Dartmouth group has played so large a part, dominated discussion of policies for controlling health care costs. In part because of that influence, discussion about cost control focused overwhelmingly on just one part of the cost equation: reducing the volume of care, rather than the price of care. As Jonathan Oberlander and I wrote during the debate, that directed attention to measures that were most likely to be unpopular, rather than measures that were more likely to be popular (Oberlander and White 2009a, 2009b). This was not only questionable politics but also badly flawed policy analysis. In this short commentary I will begin by giving evidence about the prominence of the variations argument. Then I will give some of the reasons why I believe the following:
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