Summary
In his article “The Cost Conundrum”, Atul Gawande discusses the differences in healthcare expenditures of two homogeneous regions (McAllen and El Paso), and draws the particular attention to why McAllen, the region with the lowest household income in the USA (about twelve thousand dollars) and the annual healthcare cost of about “$14,946 per enrollee, which is the second-highest in the United States (after Miami) and essentially double El Paso’s cost of $7,504 per enrollee”.
The author tries to find the answer to this puzzle and draws some interesting conclusions. Firstly, it is not a poverty rate which induces high medical costs in the region. Even though the per capita income is small, the population does not suffer from the above average number of obesity cases, cardiovascular diseases and frequent evidence of alcoholism. Secondly, the reason is not in the higher expenditures on better technologies and medical equipment (there are states and towns when they are considerably better and more sophisticated). Finally, the number of specialists and physicians is also not higher then the country’s average. As it appeared, the answer is in wasted resources. According to the author, these are predominantly inefficiencies which cause such high level of healthcare costs. Since the number of medical tests has increased over time (due to the technological progress), physicians gained more opportunities to profiteer from their patients. As it is written in the text, pay is for quantity not for quality, given that the studies showed that the higher the spendings the lower the quality of the healthcare. But not only the healthcare services get more and more overused (“more diagnostic testing, more hospital treatment, more surgery, more home care”), but also the physicians themselves have become constantly pre-occupied in business and trade. The latter questions their ethics and opportunity for bribes.
Works Cited
Atul Gawande. 2009. The Cost of Conundrum. The New Yorker, June, 1, 2009.
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