WHY IS MEDICAL CARE MORE EXPENSIVE IN SOME CITIES (COMMENT)? Dick Weisfelder commented here that “The differential between the average annual medicare expenditure in Miami of $16,000 and less than $5,000 in Salem, Oregon does not reflect better care in the former.” There are many improvements that can be made in our health care system, but one source of improvement is much more study of how some cities spend much less money for the same performance than others do. Back in the day, another young lawyer was working on a transaction involving a large chain of restaurants. He told me with astonishment that the company had no idea of which restaurants were more profitable (much less, why)—the company just didn’t do that kind of study. Atul Gutwande had a wonderful article in the June 1 New Yorker which explored why medical care is more expensive in McAllen, Texas than in nearby El Paso. One thing that stood out about the article is that Gutwande’s questions surprised professionals. They hadn’t thought about those comparisons.

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