For a clear example of our warped health care system, look no further than McAllen, Texas. The border town is second only to Miami in how much it spends on health care per person—$15,000 per Medicare enrollee, twice the national average. The problem? Atul Gawande of the New Yorker finds a town entrenched in the culture of too much medicine—patients get more tests, more hospital care, more surgery, more everything. And while those patients don't necessarily get healthier, hospitals and doctors certainly get richer.
Gawande sees it as an inevitable result of the way the current health care system works, and a cautionary tale amid talk of reform. Unless things change, expect more McAllens. "In an odd way, this news is reassuring," he writes. "Universal coverage won’t be feasible unless we can control costs. Policymakers have worried that doing so would require rationing, which the public would never go along with. So the idea that there’s plenty of fat in the system is proving deeply attractive."