McALLEN — A recent magazine article highlighting McAllen's costly healthcare market became required reading in the White House with President Barack Obama citing the city as a problem that needs to be fixed, according to an article in Tuesday's New York Times.

The recent New Yorker magazine story that revealed how average Medicare spending per enrollee in McAllen is nearly twice the national average caught the president's attention because it underlines the huge geographic variations in Medicare spending - a problem Obama wants to address, Times journalist Robert Pear writes.

Obama evidently cited the article in a meeting with two dozen Democratic senators last week, Pear reports.

"He came into the meeting with that article having affected his thinking dramatically," Sen. Ron Wyden, D-Ore., told the Times. "He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we've got to fix.'"

The article by New Yorker staff writer and Harvard Medical School professor Dr. Atul Gawande suggests that Medicare spending averages $15,000 per enrollee in McAllen because of an "across-the-board overuse of medicine."

"McAllen and other cities like it have to be weaned away from their untenably fragmented, quantity-driven systems of health care, step by step," the article states.

Gawande's article relies heavily on the Dartmouth Atlas of Health Care, which outlines wide variations among states and cities in Medicare spending.

The research has been popularized on Capitol Hill by Peter Orszag, Obama's budget director, and has apparently persuaded some in Congress to consider reducing funding to the most expensive geographic areas, Pear writes in the Times story.

When the New Yorker published its article last month, McAllen doctors were irate.

Most said the piece failed to address how the high proportion of indigent patients and doctors' fear of malpractice lawsuits help to drive up costs. Dr. Linda Villarreal, an Edinburg internist and former president of the Hidalgo-Starr County Medical Society, acknowledged that doctors order unnecessary tests to ensure they are free from liability.

The article also touched briefly on Medicare fraud and the cutthroat competition for patients among McAllen hospitals, which could also drive up costs.

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Sean Gaffney covers business, the economy and general assignments for The Monitor. He can be reached at (956) 683-4434.