A Texas Paradox, Ctd.
A South Texan-living-in-Dallas FrontBurnervian thinks the New Yorker didn’t do its homework:
The article was very insightful but to simply blame the problem on fraud and conflict of interest between physicians and diagnostic testing facilities was, in my opinion, very misguided.
If I were the journalist covering that story, I would have asked myself what percentage of the population is on medicare and/or medicaid versus the general population. I think you would find that the percentage of people in Hidalgo County who are on some form of government run health plan is significantly higher than in other parts of the country. When doctors are being reimbursed at 70% the reasonable and customary rate for the majority of the services they perform they’re going to perform more services to make up for the difference. Whether or not this is fraud is debatable, but those doctors still have to find a way to pay their staff, maintain malpractice insurance, keep the lights on, etc.
Since I happened to mention malpractice insurance, I’d venture to say that the prevalance of frivolous malpractice suits is also significantly higher in Hidalgo County than in other parts of the country. This I don’t know for sure, but, from my experience, it wouldn’t surprise me.
Finally, and this borders on a touchy racial issue, the majority of the population of Hispanic. There are distinct cultural differences with regards to medical care in the Hispanic community. For instance, your typical resident in Hidalgo County probably won’t go to their primary care physician when they have a cold or flu symptoms. They’ll either go into their medicine cabinet and start themselves on a course of antibiotics they purchased in Mexico, go to Mexico and pick up a Z-Pack for $15, or do nothing at all. This, of course, assumes they have a primary care physician. It’s just as likely that their PCP is the closest emergency room. What this creates is a situation where they’re only seeking medical care when they’re really “sick.” This would mean that only the sickest people receive treatment and, on average, the costs are higher.
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