McAllen, Texas Healthcare
In the healthcare article of the year, Dr. Atul Gawande has done some outstanding reporting: he has described the core problems of the United States’ healthcare system. He has also pointed out beacons for reform to pursue — the foremost being the Mayo Clinic right here in Rochester, Minnesota:
“It’s not easy,” he said. But decades ago Mayo recognized that the first thing it needed to do was eliminate the financial barriers. It pooled all the money the doctors and the hospital system received and began paying everyone a salary, so that the doctors’ goal in patient care couldn’t be increasing their income. Mayo promoted leaders who focussed first on what was best for patients, and then on how to make this financially possible.
That bolded statement (emphasis mine) gets to the core of the article: costs stem from doctors making decisions day in and day out. In the right circumstances, those doctors can pursue financial gain and justify it (falsely) in terms of patient care. Keep honest people honest, and your care costs drop precipitously.
Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can’t do it. Or we can turn to the local medical communities, which have proved that they can. But we have to choose someone—because, in much of the country, no one is in charge. And the result is the most wasteful and the least sustainable health-care system in the world.
If you want to be a responsible, informed healthcare consumer, Dr. Gawande’s article is VERY MUCH worth your time.