Spend More, Get Less? The Health Care 'Conundrum'

Main Category: Public Health
Article Date: 19 Jun 2009 - 5:00 PDT

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On NPR's Fresh Air, New Yorker staff writer Atul Gawande spoke about his article on the high cost of health care in McAllen, Texas. He found that costs in McAllen were higher than in the rest of the country because doctors ordered more tests and treatments for their patients, which did not result in a better quality of care. Gawande told NPR that "the difficulty comes in the conflict between when medicine is a business versus when it's a profession. In a grey-zone case, whether a patient should get that endoscopy for heartburn, whether you send them to have a particular operation like a carpal-tunnel release for carpal tunnel syndrome, we make more money, and there is a temptation and a strong incentive to do more rather than less. At the same time, if we've crossed the border to the point where over-treatment is actually producing harm, we now have to think about how to rein in that part of what we do, even though it can sometimes mean losing money."

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