so what's going on in mcallen?> the doctors are able to profit not just from being physicians like we have traditionally, but by ordering tests on equipment that they own or x-rays on equipment that they own or sending patients to facilities that they own or have a financial interest in. >> extra tests and services to patients are often referred to as utilization. >> i think that we may have high utilization because we care for a lot of very sick people later in their disease that require more care. and if you require more care, you're going to have more utilization. >> reporter: the doctor works in an ultramodern hospital in town called doctors hospital. he is one of the doctor owners of the hospital. that is also criticized by dr. dyke. he offers this characterization. >> they value money more than their patient's well-being. >> it hits me viscerally because i know it's not true. >> there's enough ethical doctors in town that still continue to send me patients, not many, but i think enough to make a living. not b

dike, but there is no doubt about this fact, per-patient costs in mcallen are astounding. mcallen has the second highest health care costs in the nation, only miami is more. but it's one of the poorest counties in the u.s. the average worker here makes about $12,000 a year, yet incredibly the average health care cost for a patient in this county is almost $15. what medicare spends for the typical spisht in mcallen is almost double what it spends on the average patient nationwide, so what's going on in mcalen? >> the alreadies are able to profit not just from being physicians like we have traditionally, but by ordering tests on equipment that they own or x-rays on equipment that they own or sending patients to facilities that they own or have a financial interest in. >> reporter: extra tests and services to patients are offer referred to as utilization. >> i think we may have high utilization because we care for a lot of very sick people later in their disease that require more care. and if you require more care, you're going to have mr. utilization. >> reporter: dr. carden

. >> reporter: gary tuchman, cnn, mcallen, texas. >>> it is go time. we are pushing forward with the next hour of "cnn newsroom" with betty nguyen! >> hello there. >>> madrid, 2004, terrorists blow up commuter trains, killing almost 200 people. colorado, 2009, investigators target a suspected plot for similar attacks right here in america. we are pushing forward on a probe that stretches from the suburbs of denver to the streets of new york city. >>> plus, scobee, montana, on the u.s./canadian border. if you can't find it, just follow the dollars from washington. now, the feds are rethinking stimulus projects that some call borderline crazy! >>> and from baghdad, the back-story. >> a cup of coffee that you don't have time to drink and the "get out of bed now we're leaving" wake-up. >> yep, you snooze, you lose, your chance to see iraq's famous shoe thrower walk out of jail. it's not your ordinary photo-op. >>> hello, everybody, i'm betty nguyen, in for kyra phillips at cnn world headquarters here in atlanta. and you are live in the "cnn and you are liv