Don’t Vilify Physicians In the Name of Reform

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Letter to The New York Times
June 19, 2009

Dear Editor,
Your editorial unfairly blames “profligate physician behavior” for high medical spending in the United States. Contrary to what the Dartmouth researchers claimed, regions with high Medicare per capita spending are not necessarily wasting money. Medicare spending per capita is an inaccurate proxy for overall medical spending. Atul Gawande, in his New Yorker article cited in the editorial, relies on the Dartmouth Medicare data to identify McAllen, Tex. as the town with the highest per capita medical spending next to Miami. But there are reasons other than physician behavior that explain Medicare costs in McAllen. It is a border town and cares for many newcomers who are uninsured and can’t pay. Therefore costs are shifted to insurance programs such as Medicare. In addition, to the extent actual medical spending per capita is high in McAllen, Dr. Gawande points out other reasons. McAllens population drinks 60 percent more than average and has a 38 percent obesity rate. Most doctors put their patients first, and many doctors provide free treatment when a patient cannot pay. What a shame doctors are being vilified in the name of reform.

Betsy McCaughey, Ph.D., patient advocate
Chairman of the Committee to Reduce Infection Deaths
former Lt. Governor of New York State


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