The cost condundrum

For those interested in health-care reform, New York Times columnist David Brooks — a moderate conservative — named this New Yorker article as the “most influential magazine essay of 2009.”

Titled “The Cost Condundrum,” the essay explores how health care costs twice as much in some areas of the country in ways that can’t be explained by demographics or better health-care outcomes. Written by Atul Gawande, a doctor himself, the central thesis is that some communities simply overutilize health-care services — and it has as much to do with what doctors do or don’t do as any other factor. (In fact, Gawande argues that the central argument of this year’s debate — whether health care should be privately or publicly funded — misses the entire point. It’s not who’s picking up the tab that control the costs, he says; rather, it’s those who order the medical services in the first place.)

I read the piece when it came out last June and reread it again last night, and it’s definitely worth a look for anybody who cares about the subject.


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