Health Care Spending Disparities Stir a Fight.

[elleng]

President Obama recently summoned aides to the Oval Office to discuss a magazine article investigating why the border town of McAllen, Tex., was the country’s most expensive place for health care. The article became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.

“He came into the meeting with that article having affected his thinking dramatically,” said Senator Ron Wyden, Democrat of Oregon. “He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we’ve got to fix.’ ”

As part of the larger effort to overhaul health care, lawmakers are trying to address the problem that intrigues Mr. Obama so much — the huge geographic variations in Medicare spending per beneficiary. Two decades of research suggests that the higher spending does not produce better results for patients but may be evidence of inefficiency.

Members of Congress are seriously considering proposals to rein in the growth of health spending by taking tens of billions of dollars of Medicare money away from doctors and hospitals in high-cost areas and using it to help cover the uninsured or treat patients in lower-cost regions.

http://www.nytimes.com/2009/06/09/us/politics/09health.html?hp

[Skittles]

1. "evidence of inefficiency"

or evidence of ripoffs?

[elleng]

4. So should McAllen, TX (see below)

be studied for evidence of 'ripoffs?' Maybe.

[Skittles]

5. YES

[Cleita]

7. One shot military style isn't going to work with this.

Put up your facts.

[Skittles]

8. I said it's a POSSIBILITY

[Cleita]

9. I guess that makes a difference. n/t

[Cleita]

2. How can Washington be so stupid.

McAllen, Texas is where old people from Middle America go to die. The town is friendly to them. They can hop over the border for dental care and cheap drugs and yes, they will overload Medicare in one area because there are so many of them in one small demographic who go there to die.

Maybe if other towns were more senior friendly, the risk would be spread out around the country and it wouldn't be so obvious.

[elleng]

3. Not stupid, just 'ignorant,'

which is why all this has to be studied.

Its a BIG COUNTRY, with lots of people and lots of towns. Personally, I've never heard of McAllen in this context. Your suggestion is good, that is, somehow promote other towns becoming senior-friendly. How did it begin? Do you know?

[Cleita]

6. When I was working in an RV park in Texas in 1995 I started to get to know

elderly RVers coming through. McAllen was a big destination for Snowbirds not only from the north but also Canada. They started by going south in the winter. Then when they got older, they found places to nest and buy little RV spots where they stayed all year and didn't bother to go north anymore. Most of them did tell me that it was where they were going to die. I was having some dental problems with no money at the time and one of the ladies, who was on her way to McAllen started telling me that many of the elderly went there to get cheaper dental across the border. They also discovered cheaper drugs there too when seniors didn't have any prescription drug benefits. Of course McAllen accommodated the seniors and of course clinics, doctors and hospitals, RV and mobile home parks were there for them. They had what they needed and warm weather. It's not the only place that has that cluster of seniors. Of course, seniors will use Medicare because as they start nearing the end of their lives, they will need more health care. DUH!!

[Cleita]

10. I have one more thing to say because I'm sensitive to this.

I'm on Medicare with a Medigap policy. Although I have access to doctors and an ER, I don't get one iota more of medical care than I need because I don't get it if I don't need it. The gate keepers make sure of it. Also, although I get a diagnosis and some prescriptions for therapy, I can't afford them even with a prescription drug benefit. So, what I get is an assurance that I'm not going to die from something yet, but if I am, I can't afford the therapy so I don't think I'm overburdening the system since it costs me out of pocket almost $400 a month even before I buy drugs. Next month I will go in for my ten minute yearly exam. You've got it. The doc spends ten minutes with me, once a year. I'm not alone. Most seniors in my economic strata get the same or even less.

[elleng]

11. I appreciate your sensitivity.

My folks lived in Florida for about 30 years, and used medicare (with a gap) as eligible. (Mother passed on in September; Dad moved to Iowa to be near my brother.) From what I can tell, they got pretty good care; can't swear that none of their providers took advantage of the system, but from what I can tell, they were able to see Docs when necessary and to receive necessary care. Dad is now in an assisted care facility, and seems like care there is quite good and not excessive. But that's me talking, from a distance.