Prevention Matters

Atul Gawande, the doctor whose recent New Yorker piece piece comparing the medical systems of El Paso and McAllen, Tex. has caused a major stir in health policy circles, says a greater focus on prevention could help reduce costs in McAllen "overnight."

"...We have not been thinking hard enough about how we control costs and make a better system," in an interview with the Washington Post's Ezra Klein. "I think it's achievable in about 10 to15 years, and maybe even faster. I can tell you three things that will transform McAllen overnight. But CBO doesn't score them."

Gawande said McAllen's average $15,000 annual expenditure per Medicare beneficiary could be reduced to $10,000 through a reduction in home visits, an increase in the use of hospice care vs. ambulance rides, and "work on basic cardiac prevention like getting people statin drugs."

"Most studies have shown you'll lower the cardiovascular disease rate by 25 percent and lower the number of procedures ordered," he said. "This was done in by Kaiser of Northern California, and they became the first community I've ever heard of where heart disease stopped being the leading cause of death."