"Getting There from Here: How should Obama reform health care?" by Atul Gawande

Stolen from Hend :)

I <3 Atul Gawande, even if I have no idea how in the world he manages to find the time to research and write these amazing articles on health and healthcare in between his inevitably busy life as a surgeon.

In this piece, he (briefly) explores how other industrialized nations happened upon their own universal healthcare programs, revealing that the change was rarely a sharp policy or ideology shift but rather a transition (often caused by a national catastrophe) which build on a country's existing system. In doing so, he urges us to realize that if universal healthcare is going to be a reality in the US, we have to follow a similar example by building on or expanding our current policies, regardless of how haphazardly put together they may seem. "The [new] system," he says, "will undoubtedly be messier than anything an idealist would devise. But the results would almost certainly be better."

Article

Highlights:

"Every industrialized nation in the world except the United States has a national system that guarantees affordable health care for all its citizens. Nearly all have been popular and successful. But each has taken a drastically different form, and the reason has rarely been ideology. Rather, each country has built on its own history, however imperfect, unusual, and untidy."

"Social scientists have a name for this pattern of evolution based on past experience. They call it “path-dependence.” In the battles between Betamax and VHS video recorders, Mac and P.C. computers, the QWERTY typewriter keyboard and alternative designs, they found that small, early events played a far more critical role in the market outcome than did the question of which design was better."

Hm. Makes me think of The Tipping Point...

"Yes, American health care is an appallingly patched-together ship, with rotting timbers, water leaking in, mercenaries on board, and fifteen per cent of the passengers thrown over the rails just to keep it afloat. But hundreds of millions of people depend on it. The system provides more than thirty-five million hospital stays a year, sixty-four million surgical procedures, nine hundred million office visits, three and a half billion prescriptions. It represents a sixth of our economy. There is no dry-docking health care for a few months, or even for an afternoon, while we rebuild it. Grand plans admit no possibility of mistakes or failures, or the chance to learn from them. If we get things wrong, people will die. This doesn’t mean that ambitious reform is beyond us. But we have to start with what we have."

"It will be no utopia. People will still face co-payments and premiums. There may still be agonizing disputes over coverage for non-standard treatments. Whatever the system’s contours, we will still find it exasperating, even disappointing. We’re not going to get perfection. But we can have transformation—which is to say, a health-care system that works. And there are ways to get there that start from where we are. "