Zócalo Public Square

We like to think we have choices, but when it comes to health care in California, geography is destiny. If you live in Clear Lake, you are ten times more likely to have an elective cardiac stent or angioplasty than if you live in nearby Sonoma -- whether or not that's the right treatment for you. Women who live in El Centro are 22 times less likely than women who live in Greenbrae to have a vaginal birth after C-section. Men living in San Luis Obispo have the highest rate of prostate surgery in the nation. When facing a decision about elective surgeries and tests, patients need two things: honest information they can understand, and doctors who make sure their patients receive the treatment they prefer. Yet all too often, patients don't understand their choices, or they leave the decision up to their doctor in the mistaken belief that "doctor knows best." Shannon Brownlee, acting director of the health policy program at the New America Foundation, visited Zócalo to discuss how these disparities happen, and wh