Controlling Health Care Expenditures

To the Editor: Blumenthal, in his excellent article on controlling health care expenditures (March 8 issue), 1 did not discuss the variation in expenditures across states and regions. With Health Care Financing Administration data, it can be calculated that per capita personal health care expenditures ranged from $2,760 in Idaho to $4,889 in Massachusetts in 1998, 2 and much of this variation persists after adjustment for factors such as residence in one state but receipt of health care in another. 3 , 4 There is no evidence that people who live in states with higher expenditures are more healthy than those who live in . . .