Health Care Reform
Imagine
an America in which more than 40 percent of a family's income goes to a
vital necessity. It is not health care today, it was food in the year
1900. At that time, over half the American work-force was engaged in
agriculture, which consisted of numerous inefficient farms with low
crop yields. The high cost of food kept us a basically poor country.
Today,
food accounts for only a small portion of our budget and labor force.
How did the United States achieve such a dramatic turnaround? In a
brilliant article in the New Yorker,
surgeon and author Atul Gawande describes how the federal government
did not impose a grand solution by decree. Instead, the government
created a series of pilot programs that showed farmers -- who held a
deep-seated fear of change -- better farming techniques from local
representatives of the Department of Agriculture.
Our
dysfunctional health care system is now strangling our country in the
same way that agriculture did over one hundred years ago. Gawande's
article details how "health-care spending will essentially devour all
our future wage increases and economic growth."
In an op-ed piece in the Washington Post,
columnist Ruth Marcus complains that current health care reform
legislation focuses solely on expanding coverage and does nothing to
curb these rising costs. Gawande disagrees.
Gawande contends
that there is no over-arching technical solution to spiraling health
care costs. "Nobody has found a master switch that you can flip to
make the problem go away." Gawande states that "much like farming,
medicine involves hundreds of thousands of local entities across the
country ... [providing] complex services for thousands of ... medical
issues... The history of American agriculture suggests that you can
have transformation without a master plan, without knowing all the
answers up front."
Gawande points out that the current Senate
bill authorizes a multitude of programs to test different ways of
curbing costs and increasing quality. "Government has a crucial role
to play here -- not in running the system but guiding it, by looking
for the best strategies and practices and finding ways to get them
adopted, county by county."
The debate over health care reform
is heated. No single approach has garnered complete support. Gawande
has an interesting take on the complexity of the problem and his article
is definitely worth reading. While the cost of not getting health care
reform right is high, the cost of inaction will likely be unbearable.
Words of Wisdom
-- Ronnie Shakes
