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?
Resources:
Atul Gawande, The Cost Conundrum, New Yorker, June 1, 2009:
http://www.newyorker.com/
Fisher et al., Foster Accountable Health Care, Health Affairs, 28, no. 2 (2009): w219
http://content.healthaffairs.
Fisher et al., Creating Accountable Care Organizations, Health Affairs, 26, no. 1 (2007): w44-w57
http://content.healthaffairs.
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