McAllen Redux
Remember Atul Gawande’s New Yorker article on health care spending differences in two Texas towns? He showed that Medicare spending in McAllen was much higher than in El Paso. Today, a new study in Health Affairs takes another look. Specifically, the authors wanted to see if the same differences could be shown for patients covered by Blue Cross and Blue Shield of Texas. The answer:
Inpatient spending for McAllen was nowhere near as high, compared to El Paso, as it was for Medicare. Outpatient care spending was less. And overall spending was also slightly lower per person in McAllen than in El Paso.
Overspending in McAllen appears to be a Medicare problem, not a health care problem.
Aha! The rest of the story.
Looks like Medicare is a dumb payer. Or at least Blue Cross is smarter.
Medicare doesn’t manage anything — they have pay claims submitted. Proponents of a single-payer health care system often tout Medicare’s low overhead as proof they Medicare is more efficient than private insurers. Yet this illustrates how much Medicare wastes.
I wander if we are going to get any retractions from Gawande?
You need to read the whole thing. Payments pick up once patients hit their 50s. What it looks like, is that McAllen has over utilization in the slecialist sector.
Steve
Do we all really think a program that spends half a trillion dollars a year is going to be effective at pricing? The most successful “government” organization is the military. If the military has this same problem, I expect Medicare to be a lot worse.