Exceptionalism or extravagance? What's different about health care in South Florida

In posing the "puzzle" of Florida exceptionalism, Victor Fuchs raises fundamental questions about Medicare's efficiency and equity. We agree that the higher spending in Florida has little to do with lower mortality rates. However, physicians and hospitals do play a large role in making South Florida different. Miami physicians are not more generous in providing heart, hip, or back surgery, procedures that beneficiaries seeking an active lifestyle might want. Instead, end-of-life care makes Miami truly exceptional: Patients in their last six months of life see more physicians and spend more time in intensive care than is the case virtually anywhere else in the world.