This is an article by Atul Gawande from the recent New Yorker in which he makes the case for major reform building on existing structures. He not only provides good examples of how other countries have evolved their health care systems, he provides a good framing and analysis of what needs to happen here in the US. In particular – two excerpts capture his message (and capture well PBGH’s effort to foster transformational change building on what we have):
“[A]ccepting the path-dependent nature of our health care system – recognizing that we had better build on what we’ve got – doesn’t mean that we have to curtail our ambitions. The overarching goal of health-care reform is to establish a system that has three basic attributes. It should leave no one uncovered – medical debt must disappear as a cause of personal bankruptcy in America. It should no longer be an economic catastrophe for employers. And it should hold doctors, nurses, hospitals, drug and device companies, and insurers collectively responsible for making care better, safer and less costly”.
And…
“It will not be 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. Be we can have transformation – which is to say, a health-care system that works”.
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