Comments on: McAllen Might Be Over Simplification, But It Is A Start http://www.healthinsurancecolorado.net/blog1/2009/07/12/mcallen-might-be-over-simplification-but-it-is-a-start/ Research and discussion of the Colorado health insurance industry and the healthcare crisis in America. Sat, 20 Mar 2010 01:19:45 +0000 http://wordpress.org/?v=abc hourly 1 By: Louise http://www.healthinsurancecolorado.net/blog1/2009/07/12/mcallen-might-be-over-simplification-but-it-is-a-start/comment-page-1/#comment-13740 Louise Tue, 14 Jul 2009 21:48:46 +0000 http://www.healthinsurancecolorado.net/blog1/?p=1218#comment-13740 Evan, Thanks for the clarification, and for reading my article too! I do see your point about how the problem of rushed health care that isn't patient-centered is a bigger issue than how we pay for health care. I think that the problems Gawande highlighted in McAllen are present in lots of places, and to some degree go hand in hand with the problem of doctors seeing 30 patients in a day. If a doctor can rush into the room, order a couple tests and write out an Rx, she can move on to the next patient quickly, earn a nice income, and continue to drive up the cost of health care. There aren't any quick fixes to the health care problem, and I agree that Gawande's article shouldn't be taken as the holy grail of what we should be focusing on in terms of reform. As I mentioned in my article, it's nice to see a dissenting view now and again. Keeps us all on our toes! Evan,
Thanks for the clarification, and for reading my article too! I do see your point about how the problem of rushed health care that isn’t patient-centered is a bigger issue than how we pay for health care. I think that the problems Gawande highlighted in McAllen are present in lots of places, and to some degree go hand in hand with the problem of doctors seeing 30 patients in a day. If a doctor can rush into the room, order a couple tests and write out an Rx, she can move on to the next patient quickly, earn a nice income, and continue to drive up the cost of health care.
There aren’t any quick fixes to the health care problem, and I agree that Gawande’s article shouldn’t be taken as the holy grail of what we should be focusing on in terms of reform. As I mentioned in my article, it’s nice to see a dissenting view now and again. Keeps us all on our toes!

]]> By: Evan Falchuk http://www.healthinsurancecolorado.net/blog1/2009/07/12/mcallen-might-be-over-simplification-but-it-is-a-start/comment-page-1/#comment-13506 Evan Falchuk Mon, 13 Jul 2009 18:27:43 +0000 http://www.healthinsurancecolorado.net/blog1/?p=1218#comment-13506 Hi Louise, thank you for reading my posts and your thoughtful comments. We tend to confuse how we pay for health care from how care gets delivered. In the last couple of decades, we have focused on how we pay for care, and increasingly marginalized the importance of medical care. The results are bad -- on the one hand doctors who try their best but can only spend 8 minutes with each patient, and on the other hand scenarios like McAllen, Texas. So, yes, we should deal with the problem of McAllen -- in fact, one has to wonder where have the federal authorities been all this time, since some of what Gawande saw is probably illegal. But the problem of doctors seeing 30 patients a day is far more common, and much more serious. And this was my point. McAllen is a convenient poster child, but Gawande's article wasn't about poster children. It was about the more difficult question of how we want to organize our health care system. That the President and others took the article and said "this is the problem we need to solve" told me that they hadn't read it - or they had stopped reading it after the part about the abuses in McAllen. I agree with your point that the Mayo Clinic was able to do what it did in part because it limited the impact of money on patient care. But it did this not because money was their focus. It was because they wanted the needs of the patient to come first. In reforming American health care, I think the needs of the patient need to come first. Thank you again for reading my posts! Evan Falchuk Hi Louise, thank you for reading my posts and your thoughtful comments.

We tend to confuse how we pay for health care from how care gets delivered. In the last couple of decades, we have focused on how we pay for care, and increasingly marginalized the importance of medical care.

The results are bad — on the one hand doctors who try their best but can only spend 8 minutes with each patient, and on the other hand scenarios like McAllen, Texas.

So, yes, we should deal with the problem of McAllen — in fact, one has to wonder where have the federal authorities been all this time, since some of what Gawande saw is probably illegal.

But the problem of doctors seeing 30 patients a day is far more common, and much more serious.

And this was my point.

McAllen is a convenient poster child, but Gawande’s article wasn’t about poster children. It was about the more difficult question of how we want to organize our health care system.

That the President and others took the article and said “this is the problem we need to solve” told me that they hadn’t read it – or they had stopped reading it after the part about the abuses in McAllen.

I agree with your point that the Mayo Clinic was able to do what it did in part because it limited the impact of money on patient care. But it did this not because money was their focus. It was because they wanted the needs of the patient to come first.

In reforming American health care, I think the needs of the patient need to come first.

Thank you again for reading my posts!

Evan Falchuk

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