WASHINGTON (AP) - A study of Medicare costs finds wide disparities across the country, and the more expensive areas don't necessarily provide better care.
For example, the study found the government paying twice as much for a patient in Miami as in San Francisco.
The dramatic differences also don't appear connected to climate or to who lives where.
The report by the Dartmouth Atlas Project, which studies medical resources, is published in the New England Journal of Medicine.
The study says one culprit is the individual doctor's decisions, which may be influenced by what medical services are available nearby.
Lead author Dr. Elliott Fisher also says it matters whether there's a medical health race among local hospitals or whether there's a single facility focused on primary care.
The report comes as Congress prepares to tackle health care reform.
The study is based on an analysis of government Medicare data from 1992-2006.