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This page contains a single entry from the blog posted on August 30, 2009 3:25 PM. The previous post in this blog was Bean goes to the fights. The next post in this blog is A heckuva fee. Many more can be found on the main index page or by looking through the archives.

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Sunday, August 30, 2009

Time's running out on that summer reading list

If you're serious about learning and thinking about health care reform, Atul Gawande at The New Yorker has done some interesting writing. A reader sends us to this lengthy piece, and there is plenty more where that came from.

Comments (4)

Gawande is nearly dead-on in his assessment of what is wrong with the American health care system. My wife, who works for one of the "good" systems Gawande mentions agrees with 90% of what he says. She does raise an interesting question that begs for an answer. She wonders about the example involving the cardiologist and internist at the Mayo Clinic. Her question is: "what the article omits is what the effect is on the patients sitting in the waiting room for the internist who has now spent an hour for a 20 minute appointment, and the cardiologist who has also left patients in the waiting room." Where she works, those waiting patients would be homicidal with the clerks, secretaries, and nurses. They don't like to wait and she's found that virtually no excuse mollifies them.

So while Gawande correctly identifies overutilization as one of the main problems with American healthcare, he carefully omits the trickle down effect of quality care for everyone else in its wake.

It was an interesting article and addresses one of the things that is very vague in any proposal I've seen - cost controls.

Merely having the govt run helath care means nothing for cost controls (cf his references to Medicare in McAllen, TX) as can be seen from most of their other ventures.

Another long read but hits a lot of the same points.
http://www.theatlantic.com/doc/200909/health-care

Dr. Gawande is going to speak in Portland on Sept. 23 (I think). Free at the Schnitz sponsored by Kaiser Pemanente.




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