Jennifer Madans (National Center for Health Statistics) stated that a scale of excellent, good, fair, and poor health is good at the extremes, but it is not very good in the middle. To know if someone is going to go into long-term care or die or will have a lot of expenditures, it is probably good at one end, and excellent is really good. But it is really bad about differentiating that big group of people in the middle. She has never been a big proponent of counting conditions either, because of the big variability in what that means. So there needs to be something else added. She said that some of the disability work is going in that direction, to really get a better composite measure of health that will be a better predictor of the use of resources. She did not think any of the surveys have that yet, but they are moving toward it, and some composite of that is going to be needed.

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