Analysis of Better by Atul Gawande Essay Example

some conclusions to the average cost of every surgery.This extensive book is called the “master fee schedule” (114). It lists costs of every surgery down to the exact penny.

Gawande explains that the surgeries listed ranges from trimming one’s nails which can cost $10. 15 to reconstructing a new born baby who was born without a diaphragm, which can cost at least $5,366. 98 (114). This basic idea for a list of costs dates back to the times of Babylon.

Gawande explains how the doctors were getting paid on a piecework salary, meaning he would receive more money if the surgery was extensive, and lifesaving.In the mid 1980s the schedule soon became modernized and insurers came together to stabilized the payment methods for these new discoveries, which they called “usual, customary, and reasonable fees” (115). In other words, Gawande states how the insurers were willingly enough to pay whatever the doctor order. However, this method and the list led to constant chaos, and many soon began to wonder between the good and bad doctors. The government intervened again, and left the figures to a Harvard economist, William Hsiao.

Gawande brings him up because he developed a formula that factored time spent in surgery, the mental affect it brought upon the doctors, and technical and physical skills as well. Gawande states how this method does flaw because who really does know if one surgery is more extensive then another. Can one really put a price on surgery? Gawande did the math and estimated that he could make up to $500,000 a year based upon his work week and the extensiveness of his desired surgeries. However, there are always those

patients who refuse to be insured and cannot pay for most surgeries.Gawande states this because this is when a doctor has to decide between being a healer or a business man. Doctors quickly learn that how much money they make does not necessarily have to deal with their overall performance.

Gawande takes a stand and is baffled by the fact that so few Americans do not have health insurance, and how many will soon lose it over time. He believes that they will not find a well rewound doctor, and if they do it will lead them into massive amounts of dept and misfortune. However, if they cannot find one their illness is left undetected and untreated.Gawande call this insurance madness the “byzantine insurance system,” and should change for people to believe in the doctor and not hate them.

The first thing Dr. Atul Gawande asked his employer was “what are the health insurance benefits like? ” (120). Without these certain benefits insurance companies cause massive amounts of chaos for the patients and the doctors. This leads a doctor to become the business man and not the healer. Doing the right thing is not as easy as one may think. We each have to take our pieces and put them to work.

As Gawande has written, there are many factors involved in becoming a successful and wealthy doctor. One factor that Gawande stresses is that one must think about the amount of pressure that is put on doctors every day. Establishing pay scales and filling out the paper work is the biggest pressure that is put on doctors daily. However, every doctor must have the drive to save

lives, and isn’t that what you want in a doctor?

Work Cited

1. Page 1. Gawande, Atul. Better, “Piecework.
2. ” New York, New York, Henry Holt and Company: 2007. Pages 112-129.