Welcome to AMSA's Health Policy and a Pint!

Health Policy and a Pint is an information source for members of the American Medical Student Association (AMSA) and anyone interested in health policy to discuss current topics in health policy over a glass of their favorite beverage in a fun and relaxing environment. We will be recommending articles monthly for your group to take to a bar, a park or anywhere you want to promote active and lively discussion. If you get fired up by what you read, we'll also give you the info to do something about it. So check back monthly, post your thoughts and raise a glass to your health!

Friday, June 19, 2009

June Topic: McAllen, TX & the Health Care Cost Conundrum

In a recent New Yorker article, Atul Gawande describes McAllen, a small town in Texas, where health spending has spiraled out of control in the past two decades. Gawande characterizes McAllen as a place where the “medical community came to treat patients the way subprime mortgage lenders treated home buyers: as profit centers.” Average per capita spending is more than $15,000 in McAllen, compared to $7500 in nearby El Paso. Much of this discrepancy is attributed to the “culture of medicine” in each of these two cities.

Questions to ponder:

  • What role does the “culture of medicine” play in skyrocketing health care costs and should this culture be regulated?
  • What responsibility do physicians have to contain health care spending and prevent overutilization of health care services?
  • How might accountable care organizations (ACOs) mitigate financial incentives for overutilization and incentivize high quality care without infringing on provider autonomy?


Atul Gawande, The Cost Conundrum, New Yorker, June 1, 2009:


Fisher et al., Foster Accountable Health Care, Health Affairs, 28, no. 2 (2009): w219


Fisher et al., Creating Accountable Care Organizations, Health Affairs, 26, no. 1 (2007): w44-w57


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