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Editorial
JAMA. 2008;299(20):2444-2445. doi: 10.1001/jama.299.20.2444

Spending on Medical Care

More Is Better?

  1. Gerard F. Anderson, PhD;
  2. Kalipso Chalkidou, MD, PhD
  1. Author Affiliations: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Anderson and Chalkidou); National Institute for Health and Clinical Excellence, London, United Kingdom (Dr Chalkidou).

Since this article does not have an abstract, we have provided the first 150 words of the full text.

According to conventional economic theory, “more is better.” The most obvious example from economics is the assumption that more money leads to more happiness. Economists also believe in the law of diminishing returns—each additional unit provides a smaller increment in happiness than the previous unit. Behavioral economists recognize that individuals frequently compare their level of goods and services with that of their neighbors and are often happier when they have more than their neighbors.1

Many studies have examined if these same principles apply to medical care. For example, are patients healthier and happier when they receive more medical care? Do the last few dollars spent on medical care provide as much benefit and satisfaction as the first few dollars? Does an individual's level of satisfaction with medical care depend on what his or her neighbors receive? Studies examining these issues have been conducted at different levels of aggregation, with …

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