Full post here (once archived, it won’t be free)

McAllen, Texas, Gawande argues, could learn a lot from the Mayo clinic’s method of de-incentivizing some ways doctors make money, and feel pressure to make money:

“Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can’t do it. Or we can turn to the local medical communities, which have proved that they can.”

Some collectivism may be necessary, and practical, to reduce wasteful spending.  It also could help to keep the discussion away from the top-down, and often once removed, visions of politics and political ideology.