Where would you rather get sick? That’s not exactly the question posed by Atul Gawande’s “The Cost Conundrum,” in this week’s New Yorker, but it might be.
The author, a physician on the faculty at Harvard Medical School, starts out by visiting McAllen, Texas, a place where health care costs are the highest in the U.S. He wants to see what lessons the U.S. might learn as we embark on a national conversation about health care.
Along the way, he also looks at the lowest-cost cities, including Rochester, Minnesota. He finds that the Mayo Clinic’s superb model of health care is also extremely cost-effective.
The key quote for me: “Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina–all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved.”
I occasionally get accused of a bias in favor of All Things Minnesotan. But after Mayo docs treated my father’s cancer and my mother’s NPH, I know this–you can’t find better health care anywhere. Nor, apparently, at any price.
Remember, Rochester, Seattle, Durham — all did it WITHOUT government involvement.
So who’s the “we” who is planning to bring costs down? This cannot be done by legislation.
I think you’re right – but there could certainly be ways to incentivize (sorry – I hate that word but it works in this context) this same kind of thing.