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I must admit that, although I have long supported healthcare reform, the onslaught of columns and op/ed pieces screaming about the cost of doing so has had me running scared. On the one hand, even the insurance industry and Big Pharma agreed a year ago that maintaining the status quo would bankrupt the system. On the other hand, a trillion dollars is a lot of money, and making it up by outing fraud in the system runs counter to probable reality.

Trying to rationalize both of these positions is difficult and makes it easier for a person to conclude that maybe we should step back and start over. But we can’t do that because we will never get it exactly right. Maybe we don’t have to resolve both questions at the same time. That is the thesis posited by Dr. Atul Gawande in his article in the December 14 edition of the New Yorker.

Comparing the current healthcare situation with farming in the early 1900s, Dr. Gawande details the development of pilot programs by the United States Department of Agriculture, including the development of the Extension Service. The complex problems farmers faced then are not unlike the problems we face today in healthcare – both arose from a myriad of causes, with no single, silver bullet solution. The pilot programs mandated by the current Senate bill might just work for heathcare like those programs started by the USDA did for farming. It is definitely worth a read.

2 Comments

  1. Gravatar for JILL PAUL RN

    Pete, everyone should be running SCARED!!!! This bill is outrageous. The cost alone is prohibitive. Why Congress & Senators don't know that, today, the uninsured get the best of medical care in any facility in the US, is beyond me - for free. We don't turn anyone away due to lack of insurance. This bill is a SHAM.

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