Costs increase, benefits lessen

The Physicians' Clinic of Iowa wants taxpayers to support its medical mall. What are banks for?

Quotes from “The Cost Conundrum” in the Annals of Medicine and “The Cost Conundrum Redux” (in the June 1 New Yorker): “I explored why two border towns in Texas of similar size, location and circumstances, McAllen and El Paso, should cost Medicare such enormously different amounts of money. In 2006, McAllen cost $14,946 per enrollee, second highest in the U.S., essentially double El Paso's cost of $7,504 per enrollee. Analysis of Medicare data by the Dartmouth Atlas project shows the difference due to marked differences in care ordered for patients - patients in McAllen receive vastly more diagnostic tests, hospital admissions, operations, specialist visits and home nursing care than in El Paso. But quality of care in McAllen is not appreciably better, and by some measures, it is worse.”

McAllen has a system similar to that proposed here. A quote to Gawande by a surgeon in the McAllen system: “There is overutilization here. Doctors rack up charges with extra tests, services and procedures. Before, it was about how to do a good job. Now it is about ‘How much will you (the physician) benefit.'”

The more costs increase, the less benefits we will get. Is this what our elected officials have in mind for our future?

Merle Ries

Cedar Rapids