That used to happen all the time. Compared with patients in El Paso and nationwide, patients in McAllen got more of pretty much everything—more diagnostic testing, more hospital treatment, more surgery, more home care. The following afternoon, I visited the top managers of Doctors Hospital at Renaissance.
But he had never been asked for a kickback before coming to McAllen. He cleared the patient for surgery, and the operating room gave her a slot the next day.
The doctors and nurses, and even the janitors, sat in meetings almost weekly, working on ideas to make the service and the care better, not to get more money out of patients. The physician spent an hour with her, sorting things out.
They figure out ways to increase their high-margin work and decrease their low-margin work. The software costs were under a hundred million dollars. Today, the cardiologist said, she would get a stress test, an echocardiogram, a mobile Holter monitor, and maybe even a cardiac catheterization.
Computerization, by contrast, is all selection and no mutation. The explosive trend in American medical costs seems to have occurred here in an especially intense form. An EKG is normal.
Unless we figure it out, health reform will fail.