Dr. Ben Smith: In health care, you can’t get more for less. Sometimes less is just less.

VTDigger

As we head into hospital budget season, Vermont remains in the throes of an ongoing debate about value in health care — how to define it, who defines it, and how we pay for it. 

There are many aspects to this debate, but one significant thread is that hospital and emergency department resources cost too much, and that if resources can be redirected to the outpatient realm, the need for those resources will go down, thereby saving money. 

It’s a tempting notion, and all of us can agree that primary care and other outpatient services are in desperate need of more resources.But it simply does not follow that hospitals and emergency departments — which care for our sickest and most vulnerable — need less, or that the services they provide, available to anyone who needs them, 24/7, are not worth the cost. 

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