McAllen is a medium sized town in the southwest of Texas, only a few miles from the Mexican border. If its Wikipedia entry is to be believed, there’s nothing particularly remarkable about it. But it suddenly achieved notoriety when it was outed by last month’s New Yorker as the place that spent more per person on health care than anywhere else in the United States, with the exception of Miami.

The article that did the damage, styled as a classic piece of investigative journalism, strong on story line and circumstantial detail, came from the pen of the surgeon and writer Atul Gawande (www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande). He was, of course, well aware of McAllen’s healthcare spending before he went there. The point of his visit was to find out why. So he interviewed the local doctors and, one by one, eliminated the likely explanations: the town’s inhabitants weren’t especially unhealthy; the treatments and technologies weren’t different from those available in many other places in the US; …