Costly Care in a Texas Town
A view of McAllen, Texas, from the McAllen hospital. (

A view of McAllen, Texas, June 2008. (Flickr/shainelee; click for full image)

The county around McAllen, Texas, on the Mexican border, has the lowest household income in the United States. And health care costs in McAllen are nearly the nation’s highest — almost double the national average.

Surgeon-journalist Atul Gawande went to McAllen to figure out why. What he found was doctors systematically milking the system — running up fees with a philosophy that put wealth before health.

America is drowning in health care costs. Here may be a reason why.

This hour, On Point: Atul Gawande on American health care costs off the rails in a Texas town.

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Atul Gawande joins us in our studio. He’s a surgeon at the Brigham and Women’s Hospital in Boston and a staff writer for The New Yorker. His most recent article for the magazine, “The Cost Conundrum: What a Texas town can teach us about health care,” appeared in the June 1  issue. He is also on the staff of the Dana Farber Cancer Institute, a professor of surgery at Harvard Medical School, and a professor at the Harvard School of Public Health. He has published two books, “Better: A Surgeon’s Notes on Performance” and “Complications: A Surgeon’s Notes on an Imperfect Science.”

Joining us from McAllen, Texas, is Lester Dyke, a cardiac surgeon in McAllen who has performed more than 8,000 heart surgeries in the last two decades. He is quoted in Atul Gawande’s New Yorker article as a critic of what’s happening in his county.

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