We already know that health-care spending and use can vary wildly depending on where a person lives. But most of that evidence comes from Medicare data, notably reports by the Dartmouth Atlas Project. Those analyses don't say anything about spending patterns for people covered by commercial insurance. A report out today from Thomson Reuters tackles that issue. It looks at spending for children, adults and seniors covered by employer-based insurance. And, like the Medicare analyses, it finds geographic variation. But the patterns for private and public insurance spending are different. McAllen, TX, for example, has been pegged by Dartmouth as one of the top-spending areas in the country. When MedPAC, a commission that advises lawmakers on Medicare, conducted its own analysis of actual use of medical services -- adjusting the raw spending figures for the health status of different groups and Medicare payment rates, among other things -- McAllen also appeared at the top of the list. That was in part because of its high use of rehabilitation and home healthcare services.