What a Texas town can teach us about health care

To me the author makes one fatal mistake in the article and that is assuming all hospitals could run as well as the Mayo Clinic. The Mayo Clinic is the best managed medical institution in the country. There are books written about it's management (http://www.amazon.com/Management-Lessons-Mayo-Clinic-Organiz...). Assuming every hospital can match it's efficiency isn't realistic.

Coming up with a universal system for anything requires planning for the worst possible scenario not the best.

that if you take enough small pseudo random samples, you'll get one far outside the norm eventually, by pure chance.

Anecdote: several years ago, I had some pain in a rather delicate area. I did some research online before seeing my doctor, and noted several likely causes for my symptoms. There was one minor ailment which seemed the likeliest culprit (and was, as it turned out).

In the course of this research, I found that several medical sites based in the US (WebMD among them) mentioned corrective surgery as a possible remedy. The UK-based sites I came across made no mention of surgery, only lifestyle changes and other palliative measures.

Lots of health care is pointless and has no net health benefit (i.e., benefit - side effect). But some is useful, and we don't want to cut that portion. This has been known for years by health care economists, and is ignored by everyone else.

As far as I'm aware, there is only good filter for determining which medical procedures are useful: the ones patients are willing to pay for out of pocket. This was the conclusion of the RAND experiment.

Robin Hansen wrote a great review article on this topic.

http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medi...

In the UK, the National Health Service pays doctors a flat fee per patient, so doctors have a powerful incentive not to provide treatment. On international measurements of how healthy the population is, the UK scores about as well as the US does (i.e., pretty mediocre for a First World country)--but the UK spends only 40% as much as the US does for health care.