New Yorker health care writer Atul Gawande is perhaps the most
influential and respected health care writer in the U.S. Liberal bloggers respect him so much that in September, they pitched him as a replacement for Ted Kennedy's senate seat. When he churns out long features on health care policy and practice, typically once every few months, they tend to send shockwaves through the debate. Gawande's latest piece on the cost controls of health care, released today,
may or may not do the same. If you work in health care or public
policy, you're probably already reading the 5,000 word opus. But for
those who want quick version, here are Gawande's key points.
- The Cost Problem "This is historic, and it is necessary. But the legislation has no master plan for dealing with the problem of soaring medical costs. And this is a source of deep unease. Health-care costs are strangling our country. [...] The reason the system is a money drain is not that it's so successful but that it's fragmented, disorganized, and inconsistent; it's neglectful of low-profit services like mental-health care, geriatrics, and primary care, and almost giddy in its overuse of high-cost technologies such as radiology imaging, brand-name drugs, and many elective procedures."
- Pilot Programs in Cost Control That's all the Senate's health care legislation provides for cost controls, Gawande notes. "According to the Congressional Budget Office, the bill makes no significant long-term cost reductions. Even Democrats have become nervous. [...] Where we crave sweeping transformation, however, all the current bill offers is those pilot programs, a battery of small-scale experiments. The strategy seems hopelessly inadequate to solve a problem of this magnitude. And yet--here's the interesting thing--history suggests otherwise."