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In his June 2009 New Yorker article, The Cost Conundrum: What a Texas town can teach us about health care, Atul Gawande (a surgeon himself) explores the reasons underlying the U.S.’s costly and dismal showing in the provision of health care. After talking with McAllen health providers he discovered,
The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine.
But, why is this the case in McAllen and not in Rochester, MN? Gawande’s surprising conclusion may require the rethinking of everything we think we know about U.S. health care.
This is a must read for anyone concerned about the state of U.S. health care and its future.
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And this puts the final nail in single payer from -of all people-Ted Kennedy; “We’re also hearing that some Americans want the choice of enrolling in a health insurance program backed by the government for the public good, not private profit – so that option will be available too.”
Great article; thanks for providing even more documentation that it the profit motive that is causing the ‘health care crisis’.
This “If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved. The difficulty is how to go about it. Physicians in places like McAllen behave differently from others. The $2.4-trillion question is why. Unless we figure it out, health reform will fail.”
And this “As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future.” pretty much sums it up.
One truly easy step that could be taken would be to reduce the ‘tuition costs’ associated with being a physician with such benefits being reduced when someone wants to be a ’specialist’; drive home the point that being a physician isn’t about the money.
As an uninsured person who always pays his medical bills out of his own pocket, I resent the exaggerated and biased conclusions of the Kennedy plan which assumes that insureds are paying my tab.
You can tell the folks in D.C. that I won’t enroll in their for-profit health insurance plans. I have studied the outcome of the Massachusetts’ health care plan and Kennedy’s sounds like another sell-out to the medical insurance industry.
Baucus claims that single payer cannot garner any votes: That is a bare faced lie. It has seventy something cosponsors in the House. He sold out to the insurance companies.
President Obama is asking his grassroots to come on board to advocate for health care reform on June 6th. I support his efforts but now question if he is serious about his goal to promote true reform.
After reading this, I would say that “he is serious about his goal to promote true reform” except that he is NOT sincere and it won’t be ‘True’ reform.
‘True’ reform would be a single payer system,not the bastardized legislation with a ‘public option’ that doesn’t really compete -’gain an advantage or triumph over- with the for profit system.
But Hey, look at what the powers that be are doing in the ‘financial world’ to see what is coming down ‘healthcare’ wise.
Agree. Definitely a must-read article. I hope to do something on this soon.
Yes, the “greed-convergence” in this country is becoming pretty stunning. It’s not encouraging that physicians appear to be hot on the trail of the banksters. We can only hope that the Mayo contingent wins out in the end. The other thing that I found deeply disturbing about the article was that if Gawande is correct, the current political efforts may end up missing the mark in any case. If the health care cost spiral continues in the wake of reform we’ll have a real mess on our hands.
I’ll be waiting with bated breath for your piece. I’m a long-time admirer of your writings.