When you look across the spectrum from Grand Junction to McAllen—and the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue [emphasis added].
I found the Atul Gawande article from this article, which talks about the 3 key parts of the news that you usually don't get (historical context/big picture, sources of the information, what we don't know).
What Gawande did was to structure his search for truth as a quest narrative. Instead of hiding the details about how he comes by his information, he makes that the very focus. Along the way, he makes us apprentices in his quest for truth. We finish the article with a highly refined sense of how Gawande has acquired and verified the information he presents, as well as a framework for further inquiry of our own.
Back to Gawande's article, this is a great analogy and really hits home for me (pun was NOT deliberate):
Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.
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