Unless you’ve been under a rock for the last year-and-a-half, you’ve read Atul Gawande’s now-famous New Yorker article about the highly disparate levels of Medicare spending in the Texas towns of El Paso and McAllen. It was an interesting, well-written article, and it made a compelling case for health reform, which is why everybody, including President Obama, referenced it often.
But Medicare isn’t exactly ideal for studying the entire population, because its beneficiaries are either elderly and/or disabled. While that’s a significant population, it leaves a lot of people out. So, some clever researchers went back and looked at El Paso and McAllen, focusing on spending among the non-Medicare population, and they found that the eye-popping differences Gawande originally reported almost completely disappeared. Younger, healthier people are different–or the way physicians treat them is different. Either way, something is different.
The Incidental Economist’s Aaron Carroll takes a look at the Gawande article and the new Health Affairs study in chart form, and tells you all you need to know. You should read it, just so that when you’re at a party and someone says, “Can you believe Gawande’s article in the New Yorker?! How can spending be so much higher in McAllen than El Paso?!” You can say, “Yes, I know, it’s striking, but did you know that the same spending differences between McAllen and El Paso don’t exist in the non-Medicare population?” At least, these are the kinds of parties to which I find myself going.