Obama's Healthcare Letter

The White House released a letter today from President Obama to Senators Ted Kennedy and Max Baucus, outlining his priorities for health care reform. As Time's Karen Tumulty points out in a blog post this afternoon, the president's top priority appears to be cost control. (Tumulty talked with us about her own reporting on healthcare not too long ago.)

Obama writes:

I want to stress that reform cannot mean focusing on expanded coverage alone. Indeed, without a serious, sustained effort to reduce the growth rate of health care costs, affordable health care coverage will remain out of reach.

In our first hour today, surgeon and writer Atul Gawande offered a vivid case study in out-of-control health care costs. His latest piece for The New Yorker is a remarkable report on McAllen, Texas, one of the most expensive places in the country when it comes to health care. He concludes that doctors themselves have a lot to answer for, in a system that too often puts profit ahead of health and leads to the widescale "overuse of medicine." Gawande writes:

About fifteen years ago, it seems, something began to change in McAllen. A few leaders of local institutions took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.

There's a good discussion of today's hour with Gawande in the show's comments section.  Tell us what you think.