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| No. 10 | 
Sep 29, 2009, 06:00 PM
 Re: THE COST CONUNDRUM What a Texas town can teach us about health care. Originally Posted by NickiLaughs  Excellent article, thank you for that.
You're quite welcome. I thought that this was a fantastic article that made an honest, objective and comprehensive analysis of this issue.
As he states in the article, he controlled for factors that may have influenced/explained McAllen's disproportionately high cost of care for it's medicare patients. Yes, it is a border town but so is El Paso and they have much cheaper costs. The red herring of illegal aliens that many Republicans are trying to use to obfuscate healthcare reform isn't even an issue in this case as illegals do not receive Medicare. McAllen had similar morbidities and similar medical technologies.
The clear and obvious difference is the manner in which services are compensated - namely healthcare is compensated by how many procedures are done and not by evidence based patient outcomes. It's as simple as that.
The author covers all of these points, counterpoints, and other considerations better than I possibly can. I really do encourage the allnurses community to read this in it's entirety.
 | | Advertisement Sponsored Links | | | | No. 11 |
Sep 29, 2009, 06:31 PM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care.
Who are the uninsured in America? (sorry, this is a 2006 governmental result compilation)
43.1% are NONCITIZENS
| | No. 12 |
Sep 29, 2009, 06:51 PM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care. Originally Posted by Anyone Who are the uninsured in America? (sorry, this is a 2006 governmental result compilation)
43.1% are NONCITIZENS
Sorry, I don't see what that has to do with huge discrepancies in healthcare spending on Medicare recipients (all of whom are, by definition, insured) in different regions of the country ...
| | No. 14 |
Sep 30, 2009, 02:40 PM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care. Originally Posted by RNnbakes well written article by Gawande. One of the highlights of the article was when he likened providing healthcare to building a house. Great analogy.
Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.
Very adept analogy.
| | No. 16 |
Oct 03, 2009, 01:09 AM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care. Originally Posted by TiffyRN I don't have any stats. I am surprised their median age is higher than those other cities. All I know is from visiting McAllen (where I have relatives that live there in their retirement) and seeing city-sized communities of trailer parks (all retirees).
Once more, I'm not debating the author of the article, I agree with him. I'm just trying to understand why this one city has particular disparities in income vs. cost of medical care.
A lot of the trailer park retirees are what we call "Winter Texans", northern retirees who migrate to McAllen in October and stay till May, to avoid the northern winters. Most of them are not considered residents of McAllen, but rather are still classified as residents of whichever city and state they were originally from.
Not saying to we don't have a number of them that are year round residents here, but a large portion of them are temporary residents and probably wouldn't be included in the median age reports.
EDIT: Well sure, KAR38 said the same thing I did, and probably better. But I didn't read her/his post before I opened my mouth, now did I?
| | No. 17 |
Oct 04, 2009, 09:41 AM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care.
One area that needs to be looked at is the question:
Are providers 'farming the government?" Its my understanding that McAllen has a situation where the providers own the hospitals, clinics and labs. I have no problem with that as long as they aren't using the rules to squeeze ever possible nickel out of the system.
| | No. 18 |
Oct 04, 2009, 10:30 AM
Re: THE COST CONUNDRUM What a Texas town can teach us about health care. Originally Posted by HM2VikingRN One area that needs to be looked at is the question:
Are providers 'farming the government?" Its my understanding that McAllen has a situation where the providers own the hospitals, clinics and labs. I have no problem with that as long as they aren't using the rules to squeeze ever possible nickel out of the system.
I think that was the point of the articles, actually. The facts suggest that healthcare costs in McAllen are inflated because that capitalist model promotes "squeezing every nickle out of the system". No problem with the concept of capitalism in general, but, as a country we must protect ourselves from the ugly step-sister to capitalism...greed.
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