To fix healthcare, we need to focus on where we are, not just on where we want to go
Sep 15, 2009
Idealists on both sides of the healthcare debate have very defined ideas of what our healthcare system should look like. Atul Gawande uses this New Yorker article to explain why we need to ignore the idealists on the left and the right, and take a more pragmatic approach to fixing healthcare.
A variety of countries have healthcare systems that give better outcomes than the United States, but all of those countries (Britain, France, Switzerland) started with what they already had in place and expanded on it, rather than relying on an idealized solution and completely overhauling the system in order to implement it.
Gawande goes through the various systems we already have in place in the United States, defines what our goals should be in terms of improving the existing system, and then explains how we could expand upon each of those different existing systems to meet those goals. He also shows how implementing an idealized system (like we did with the prescription drug benefit for the elderly in 2003) can be disastrous in outcome.
I found this article extremely well written, and as usual with Gawande's work, transformative in terms of how one thinks about improving healthcare. His explanation of how different countries ended up with improved systems was brilliant, and his summary of our goals was well reasoned. I highly recommend this article as a starting point for anyone looking to understand the healthcare debate.
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About the reviewer
Ari Miller (ari1974)
I mostly write about my main obsession, tennis. When I'm not experimenting with new tennis racquets, I love to watch a good movie or read a great book. I'm a fan of both non-fiction (especially books … more
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