Saturday, May 30, 2009  Atul Gawande on Cost and the Soul of
American Medicine  Atul Gawande's superb article - "The Cost
Conundrum" - in the June 1 issue of the New Yorker magazine is
long (7500 words) but brilliantly written and researched. It
won't teach anything new to policy wonks like me who've been
fulminating about health care costs ad infinitum, but Gawande
makes his analysis wonderfully understandable and persuasive for
non-wonks by developing it through beautifully realized stories.
I especially recommend the piece to the 20% of the readers of
this blog from outside of the U.S. - it's an embarrassingly
revealing view of the pathology of our health care system.
Gawande's core argument is that we are largely paying for health
care as individual piece work, and rarely provide support for
coordinated, population-based care. He makes his point by
comparing McAllen, Texas to the Mayo Clinic and Grand Junction,
Colorado, which achieve superior results at 1/3 the cost. He
quotes Dennis Cortese, CEO of May