New Yorker health cost conundrum piece sparks debate

A recent New Yorker article pointing to the disproportionately high health costs in one Texas town has fueled discussions among President Barack Obama and other reformers about the need to control regional variations in health spendingand generated protest among some Texas physicians who say the spending is warranted.

Doctors in McAllen say that in Gawande's original article, he neglected to take into account the unique nature of the case mix in McAllen, while Gawande responded by noting that his analysis did indeed take into consideration income levels and case mix in an appropriate comparison group of El Paso Texas.

(SOURCES: Advisory Board Daily Briefing,, June 25, 2009; HealthLeadersMedia,, accessed July 6, 2009)