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Healthcare scorecard, El Paso v McAllen

From the Washington Post, an interview with Atul Gawande, the author of New Yorker article comparing the medical systems of El Paso and McAllen. An excerpt from the interview:

The interesting thing to me is not that McAllen is different from elsewhere. it’s that El Paso is different than McAllen. They have the incentives to go in that direction! My hypothesis is that communities have local anchor institutions that foster values and norms that make the medical system successful. My sense is that in McAllen it was about a few institutions striking out in different ways that set the norm for what others did.

In the early 90s, McAllen was the same cost as El Paso. Three years later, they jumped into the top 10 or 20 and never really left. The first thing to really leap in price was home health care and it happened, it seems, because a few home health agencies came on the scene and began offering doctors something serious for their involvement: extra salaries as medical directors who don’t really do much. McAllen is also on the leading edge of for-profit innovations. They were early with a specialty hearts center, for instance, and cardiovascular operation rates began climbing. Then you had physician-owned imaging centers and physician-owned surgery centers and everything began going up a lot.

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Written by newspapertreeelpaso

June 24, 2009 at 1:17 pm

Posted in Uncategorized

6 Responses

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  1. El Paso and McAllen are in the Top TEN of poorest per capita cities in the USA. What McAllen has that El Paso does not is a very large service area of retired people with Medicare! El Paso DOES NOT!(probably because of our HIGH property Taxes).
    Do not blame the physicians for opening a practice in a locale where they can make a living providing healthcare. Not so easy here and therefore severely limits our physician recruiting.
    The problem with experts from back east is they live back east and there, they have lots of everything!

    El Paso Doctor MD

    June 24, 2009 at 2:49 pm

  2. Washington Post

    An Interview With Atul Gawande

    By Ezra Klein | June 23, 2009; 6:48 PM ET

    You’ve gotten some pushback on your article about McAllen, Texas. Today, in fact, some doctors from the area held a press conference rebutting your claims, and you published a blog post re-rebutting theirs. What have you found to be the most convincing counterarguments against your piece?

    See the rest of the interview:

    http://voices.washingtonpost.com/ezra-klein/2009/06/an_interview_with_atul_gawande.html?hpid=news-col-blog

    See Gawende’s 6-23-09 blog rebutting McAllen doctors press conference:

    http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande-the-cost-conundrum-redux.html

    O. C. Jones

    June 24, 2009 at 6:20 pm

  3. As Dr. Gawande points out in the interview, medicare/medicade expenses for Snowbirds when their in McAllen is charged to and counted back in their home state — not in McAllen.

    O. C. Jones

    June 24, 2009 at 6:24 pm

  4. So then the local cost in McAllen is less????…where did the $ amounts come from if counted in their home state…the alleged high/ overutilization is similar to Florida (lots of retired folks). Do the retired folks there go back home for care or just their bill?
    Do the good people around McAllen complain because there are not enough physicians, hospitals or do not have access to healthcare. Pres. Obama implies that the “physicians” in McAllen “are bad” by just looking at a healthcare costs. I contend the people in McAllen have GOVERNMENT UNIVERSAL HEALTH CARE and ACCESS! They have a GREAT DEAL!
    What is the problem? And if you think this is expensive…wait until everybody has FREE Healthcare!

    El Paso Doctor MD

    June 25, 2009 at 11:22 am

  5. It appears that you haven’t read the original New Yorker article, the rebuttal in the New Yorker to the McAllen area doctor’s press conference and the Washington Post interview rebuttal.

    O. C. Jones

    June 26, 2009 at 4:37 am

  6. Yes, I read the tainted article from “NEW YORK CITY”. But I do not blame McAllen for providing government funded universal healthcare. Insurance does not guarantee ACCESS nor control costs.
    It appears you are not a PHYSICIAN and do not understand the daily complexity and paperwork of providing health care to the sedentary, carefree & litigious population of this country. Healthcare Doctor-dot-Gov is now quickly moving to become single payer with further mandates to OVERREGULATE, UNDERFUND and readily attorney general PROSICUTE. We already have ‘free’ USA Emergency Room care and hospitalization(unfunded government mandate) with
    1-800 TV-n-Radio attorneys on call for bad outcomes.
    Hopefully now YOU understand that the only way to have power over costs is to control care or level of access!
    The obvious is that the Government can & will deny care but physicians and their patients will continue demand it! The Canadian healthcare system readily comes to mind.
    How to pay(TAX )for free health care is the unanswered question. California, for example has liberally overspent & taxed and is now very BROKE.

    My prayer to the American Public is take care of yourselves and do not get hurt. Amen.

    El Paso Doctor MD

    June 26, 2009 at 9:59 am


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