Trivia question: in what market does Medicare spend the most per patient? Answer: Miami. Not surprising; tough demographics and high cost of pretty much everything (and who can forget the first two seasons of Nip/Tuck?)
Harder question: what market is #2? In a nifty piece of reporting, Atul Gawande tells us the “why” behind the surprising answer: McAllen, TX. Basically, docs in McAllen are especially “entrepreneurial,” meaning that the average internist has insinuated himself into as many pieces of the health care business system as he can (think owning strip centers where home health agencies are tenants). Gawande contrasts this model of care with that of the Mayo Clinic which, ever-so-quaintly, puts actual patient needs at the center of its mission.
The answer to trivia question #3 will make you a big hit at any cocktail party where the attendees are health care policy geeks. What’s the ratio of Medicare spending per person to the average income per person in Mc Allen? Big finish:
125% . Average income is 12k; average Medicare expenditure, 15k. Unbelievable, assuming Gawande is believable.
A must read for people like me who are health care naifs. The interview is good, too.
