The Truth About Healthcare: More is Not Always Better

For those who are concerned about health care, health care costs, and health care reform, I highly recommend Atul Gawande’s report from McAllen, Texas, where Medicare spending is twice the national average.  From The New Yorker: 

It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here.

McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.

The explosive trend in American medical costs seems to have occurred here in an especially intense form. Our country’s health care is by far the most expensive in the world. In Washington, the aim of health-care reform is not just to extend medical coverage to everybody but also to bring costs under control. Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It’s also devouring our government. “The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”  [full text]

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3 responses

  1. Kiersten, great minds think alike. That article is excellent, it’s long but so interesting it’s not work to read it. Gawande has been quoted in many other editorials because he shows the stark difference between profit-driven medicine and patient-centered medicine.

  2. Kiersten Marek | Reply

    Yes, I just finished reading and it is amazing to think of the implications. I can see why President Obama wants this discussed.

    Also, as a practitioner (albeit an extremely low practitioner on the totem pole) I appreciate the need to stay patient-centered. I noticed that the article did not reference the cost of behavioral health (counseling) as being unusually high in McAllen. I would be interested to know the statistics nationally for medicare spending on behavioral health. Sounds like a good research project for a Kmareka blogger!

  3. [...] out-of-context concept is ‘more is better’. Kiersten wrote about a classic NYT article by Dr. Atul Gawande contrasting two Texas towns. They were much alike [...]

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