Saturday, January 22, 2011  Gawande and O-Mama-Care  Atul
Gawande's latest piece in the New Yorker is out this week and I
suspect the raves will be soon to follow. President Obama is
assuredly frantically scrambling to slide a reference to it in
his upcoming State of the Union Address.  The article deals with
a possible solution to the conundrum of "high utilizers" in the
health care system. By "high utilizers" (HU's) we mean those 1%
of patients who, due to a combination of generalized sickness/
non-compliance/poor physician management, account for gargantuan
shares of systemic health care costs (sometimes up to a third of
all hospital expenses). Gawande investigates why this is the
case and hangs out with a couple of idealistic physicians who
may have stumbled upon a potential fix.  Unsurprisingly, HU's
tend to come from lower socioeconomic classes. The diabetic who
doesn't have health insurance and only rarely seeks medical
attention for severe complications of his diabetes in an ER is
obviously going to a