Tuesday, February 3, 2009

Health Care Pragmatism

Atul Gawande has written a thoughtful piece in a recent New Yorker on the prospects for health care reform in the USA that suckerpunches the entire debate by considering history in all its ideology-confounding messiness:

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.
Gawande sketches how successful health care systems have not sprung into existence from someone's beautiful vision, but have built on and expanded what already works. This is not what dreamers of the left (single payer now!) or the right (more haggling with doctors now!) necessarily want to hear -- as a card-carrying dreamer of the left on this matter, I can attest to half of that -- but it makes a lot of sense.

Whether or not it represents the last word on the subject, it's worth a read.

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