Become informed and defend your freedoms.  This is a website for citizens by an independent citizen.

The politics of Healthcare need reform

Obama's Whiz Kids

What does any of this have to do with health care? A lot. The Obama administration is crawling with similar whiz kids like Peter Orszag, Ezekiel Emanuel (Rahm's brother), and outside advisors like David Cutler and Atul Gawande who are similarly convinced of their own genius and think they can create the data-driven management systems to eliminate $700 billion of wasted care in the American health care system. Like Mr. McNamara, they are dismissive of any skeptics--when they are even aware skeptics exist. And like Mr. McNamara, their very hubris causes them to overlook essential factors that may impede their plans.

For example, Dr. Gawande had an article published in The New Yorker about a month ago that laid out in great detail what he viewed as the inadequacies of the health care system in McAllen, Texas and compared them to what he views as far superior systems in Grand Junction, Colorado and Rochester, Minnesota (home of the Mayo Clinic). He concluded that we needed to replicate the management systems (not-for-profit, salaried employees, team approaches to service delivery) of the Mayo Clinic in places like McAllen, and indeed, throughout the United States. Voila! Problem solved.

Well, that's all very nice, but now comes the Texas Medical Association with a reality check on some of the issues Dr. Gawande missed. Some of the things he somehow overlooked about McAllen include:

Its population is the poorest in the entire United States;

It has the fewest physicians per capita in the entire United States;

It has the second highest uninsured rate in a state that is the Uninsured Capital of the United States;

It is heavily reliant on Medicaid and Medicare payments to finance its entire health care system; and

It is plagued by very high rates of obesity, diabetes, lack of exercise, and overall poor health status.

The article explains, "Where there is poor availability of outpatient care, patients are far more likely to seek routine care in hospital emergency rooms, where costs are high and diagnostic testing is more frequent. This is also far more likely to result in costly hospital admissions. The data that Dr. Gawande depended on--but did not report--show just this. McAllen has a pattern of unusually high inpatient costs, while outpatient costs are close to average."

Golly, the data were right in front of him, but he chose to ignore them.

SOURCE: Border Health Caucus