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A commonly held belief states that paying more for a product is an assurance of higher quality. The adage “you get what you pay for” has been the conventional wisdom for many prospective buyers, whether they are debating buying a new vs a used vehicle, buying an index vs a managed mutual fund, or paying tuition at a public vs a private college. Recent US economic doldrums have given all of us pause, however, causing many to question the fiscal sagacity of overspending. Worse yet, evidence suggests that spending more for a product may not equate with better value. The same principle seems to apply to health care, as highlighted in this issue of JAMA Surgery. The well-written article by Ejaz and colleagues1 adds additional fuel to the fire surrounding the debate on health care spending. The authors found that increased spending at the time of index hospitalization for major abdominal surgery correlated with a higher likelihood of readmission.
Schwed AC, de Virgilio C. Targeting Future Health Care Expenditure Reductions. JAMA Surg. 2016;151(8):725. doi:10.1001/jamasurg.2015.5556