The Dim-Post

May 29, 2009

Good journalism o’ the day

Filed under: health — danylmc @ 8:00 am

Atul Gawande who is a Professor of Surgery at Harvard as well as a contributing writer for the New Yorker goes to McAllen, Texas, which is one of the most expensive places in the US (and thus the world) for healthcare:

In recent years, we doctors have markedly increased the number of operations we do, for instance. In 2006, doctors performed at least sixty million surgical procedures, one for every five Americans. No other country does anything like as many operations on its citizens. Are we better off for it? No one knows for sure, but it seems highly unlikely. After all, some hundred thousand people die each year from complications of surgery—far more than die in car crashes.

Obviously the US has a different health care system to us, but the core problem – that they’re spending a lot more money for little gain, and even arguably worse outcomes – seems very relevant.


  1. Yeah they spend a bomb on health per capita, relative to everyone else. One of the no doubt many anecdotal explanations is that US health patients are much more demanding for their health insurers to ‘do something’, so an arm in a sling for a week turns into surgery and a few nights in hospital instead.

    Token No-the-US-does-not-have-a-free-market-health-system comment.

    Comment by StephenR — May 29, 2009 @ 8:24 am

  2. @stephen sure they have better health outcomes that everyone else though? all that money must amount to more than a bloated insurance bureaucracy?

    (nested comments are a pain in the arse)

    Comment by Che Tibby — May 29, 2009 @ 9:24 am

  3. (nested comments are a pain in the arse)

    Perhaps you should seek surgery for that?

    Comment by Sam — May 29, 2009 @ 9:32 am

  4. @Che, I wouldn’t know if they have better outcomes. I do know that the quality of the outcomes are highly variable though.

    Comment by StephenR — May 29, 2009 @ 9:37 am

  5. meh. it’s elective, so i’ll be on the list for too long.

    Dr. Surgeon-Guy: “hmmm… nesting arse… we’ll issue you some panadols, and just try to lean a little when sitting for 6-8 months until we can get you into surgery”.

    Comment by Che Tibby — May 29, 2009 @ 9:39 am

  6. Or did I mean the access to quality outcomes are highly variable? Been a while since I talked about this.

    Comment by StephenR — May 29, 2009 @ 9:51 am

  7. i’m thinking both. access is definitely governed by income, and outcomes are likely to vary within bands of access.

    Comment by Che Tibby — May 29, 2009 @ 10:04 am

  8. It’s not just the bureaucracy. The hospitals are also in competition with one another to spend bazillions on the latest nuclear device that doesn’t necessarily improve outcomes. But if one hospital has it, they all have to have it. There was an article in the times that I can’t find anymore, but this one kind of makes the point

    Comment by Jake — May 29, 2009 @ 10:40 am

  9. A monorail!!



    Comment by Che Tibby — May 29, 2009 @ 11:06 am

  10. Exactly. And no chance that the tracks will bend.

    Comment by Jake — May 29, 2009 @ 11:43 am

  11. YEah
    But if you’re on the low-outcome end you can make your kids rich when you die by suing quick!

    Comment by Dave Strings — May 29, 2009 @ 1:33 pm

  12. Danyl’s article covered state-funded but private-provided healthcare, Medicare, unless I misunderstood. I’m not sure if there are leasons there for a either pure(ish)-socialised country like NZ or UK nor a pure(ish) private funded/insurance-based system like folk belief the US has. What is described seems to be the worst of both worlds.
    When the funder/insurer owns/controls the hospital, the outcomes (or rather control over spending) seem to be better balanced. And that would be the HMOs of the US?

    Comment by Clunking Fist — May 29, 2009 @ 2:36 pm

  13. Comment by Clunking Fist — May 29, 2009 @ 2:42 pm

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