A Texas congressman is seeking a Government Accountability Office study on why Medicare costs in the McAllen area are almost double the national average.

U.S. Rep. Michael Burgess, R- Flower Mound, said his request was spurred by an explosive article in The New Yorker magazine that concluded physicians were overutilizing expensive tests and services to rake in government fees. He asked House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., and Ranking Member Joe Barton, R-Texas, to request the study.

The article, written by surgeon Atul Guwande, used Medicare payment data to compare McAllen to El Paso, another Texas border community. Among the findings were that critically ill Medicare patients in McAllen received almost 50 percent more specialist visits, were two-thirds more likely to see 10 or more specialists in a six-month period, and got 550 percent more urine-flow studies to diagnose prostate problems.

Patients also got two to three times as many pacemakers, implantable defibrillators, and heart bypass operations, and five times as many home health care visits.

All told, Medicare in 2006 spent $15,000 per enrollee in a region with a reported $12,000-a-year per capita income. The only place billing more was Miami.

“I am concerned that without an independent analysis and without further examination of what exactly is taking place in McAllen's health care spending, Congress will be inclined to make broad assumptions that lead to inappropriate legislative decisions about how to control costs in health care,” wrote Burgess, who is a physician. “These decisions will not properly address the challenges of overall spending reductions in McAllen, or elsewhere in the country.”

President Obama, on a full-throttle campaign to overhaul the nation's $2.2 trillion health care system, reportedly made the article required reading within his administration.

Doctors in McAllen responded by inviting Obama to come down for himself.

Lacking health insurance means many forego care until they get their Medicare card, they say, and by then are in the advanced stages of diseases that could have been prevented. The “medical home” for many is whichever emergency room has the least crowded parking lot.

The physician-owned hospitals surrounded by blocks and blocks of testing centers and specialty care offices are long overdue, some doctors say, considering the region's population growth — one hospital alone each month delivers an elementary school's worth of babies.

They also argue that El Paso has an average income that's about a third higher and is not a fair comparison.

“We certainly welcome Congressman Burgess and anyone who would like to come down to take a look for themselves to see what's actually going in South Texas to get a better idea of the population we serve and the chronic illnesses that we care for,” said Dr. Carlos Cárdenas, chairman of the board at the physician-owned Doctors Hospital at Renaissance. “All of those things I think are certainly germane to any discussion as we move forward towards health reform.”


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