Analysis of The Cost Conundrum Article by Atul Gawande - Term Paper Example

The article by Atul Gawande (2009) published in the New Yorker raises fundamental issues about the way American citizens receive their health care from their local hospitals and doctors. It has already been demonstrated that there are some differences in the allocation of resources according to the racial and ethnic neighborhood that people live in (Nelson, 2002) and there are ongoing debates about how to reform health services in order to eliminate this kind of unfairness.

Some scholars suggest that the system has drifted out of control: “Through no planned design or evil intent, our health care system has evolved in ways that better serve a myriad of economic, professional, and political interests than those of patients and families, and the larger public” (Mechanic, 2006, p. ix). Gawande, however, sees a much bleaker picture and suggests that there are areas in America where doctors and administrators are financially tied into the provision and that this encourages massive amounts of over-treatment, with no benefit to patients.

Gawande’s article describes a huge discrepancy in the per capita costs of medical care in two comparable districts, McAllen and El Paso, Texas, while there is no evidence that the higher cost location (McAllen) offers better care or achieves better results. This gives rise to a serious ethical problem: in El Paso patients have much lower rates of access to all kinds of tests and treatments, while in McAllen, they have much higher rates. The variation is due to doctor behavior, and not down to the demographics of the citizens since the two regions are very similar.

This is the kind of situation that led to the passing of the 2010 Health Care Reform bill which aims to extend health coverage to from 83% to 95% of the legally resident population. (Tumulty, 2010, p. 1) Unfortunately, however, huge variation in the way that this money is spent will mean that fair and equal service is not likely to happen. From the point of view of justice or fairness, such unequal practices cannot be defended, since all American citizens should have equal access to the benefits of our modern technologies.