Slogging through a 12th day of debate on the legislation, the Senate found itself at an impasse over a proposal to allow imports of low-cost prescription drugs from Canada and other countries. ...NYT
With the news that the Senate has "hit a roadblock" according to the New York Times, we fall back into a slough of despond. The first thing to remember is that we are living on a street where there's a Republican bully who doesn't want us to get anywhere. Every time we try to walk to work, the bully reappears.
Remember: even if/when a bill is passed, it's only a beginning. On the other side of a "health care reform bill" is the job of finding which reforms work, which new measures are needed, which problems are intractable. And that takes time.
There are, in human affairs, two kinds of problems: those which are amenable to a technical solution and those which are not. Universal health-care coverage belongs to the first category: you can pick one of several possible solutions, pass a bill, and (allowing for some tinkering around the edges) it will happen. Problems of the second kind, by contrast, are never solved, exactly; they are managed. ...Atul Gawande, New Yorker
Atul Gawande is the physician/writer who turned the health debate around last summer when the New Yorker published his research into excessive health care costs in McAllen, Texas.
In his latest article, he compares the development of an effective health care system in America with the development, a century ago, of better and more productive agricultural practices.
At the start of the twentieth century, another indispensable but unmanageably costly sector was strangling the country: agriculture. In 1900, more than forty per cent of a family’s income went to paying for food. At the same time, farming was hugely labor-intensive, tying up almost half the American workforce. We were, partly as a result, still a poor nation. Only by improving the productivity of farming could we raise our standard of living and emerge as an industrial power.
Trial and error? Pilot programs? Democrats feel pressured to produce legislation enabling a flawless, wholly predictable health care system. Dr. Gawande -- open-minded and experienced -- knows that's impossible.
Just enable change and growth.
Knowledge diffuses too slowly. Our information systems are primitive. The malpractice system is wasteful and counterproductive. And the best way to fix all this is—well, plenty of people have plenty of ideas. It’s just that nobody knows for sure.
