The New Yorker has an amazing piece on health care. Read this article by Atul Gawande, a Boston surgeon if you are interested in health care costs, health care reform, and why we should talk about health care not health insurance. If you can only read one page (which I never recommend, but I’m realistic), skip to pp 6.

Short version: the point isn’t who’s paying. The point is whether profit or care is privileged. Comparing apples to apples of population demographics and socioeconomic factors, too many tests and surgeries, mean higher costs to everyone—insurers, patients, and government—which actually makes patients less healthy. The more we spend, the worse care gets. Sometimes because docs are padding their wallets. Sometimes because the medical culture’s priorities are wack. Not because of malpractice or technology.

And the best health care? Collaboration and best practices seem to be key. In one case, the Mayo Clinic, salaries help keep costs way down because docs focus on getting people well the best way possible. And their quality far outstrips those hospitals, towns, and cities that cost the most. Ditto elsewhere that docs simply come together and agree to collaborate and root out poor care, though they’re not salaried.

So are we going to focus on patients or revenue? Read the article and help your national representative decide.