Earlier this month, Atul Gawande published an article in the New Yorker about health-care reform and curbing costs. Today Alain Enthoven, an emeritus professor at Stanford's business school, published a response to Gawande's piece on the Health Affairs Blog. Enthoven writes:
Gawande acknowledges that the cost of health care "...will essentially devour all our future wage increases and economic growth. The cost problem, people have come to realize, threatens not just our prosperity but our solvency." "So what does the reform package do about it? ...Does it institute nationwide structural changes that curb costs and raise quality? It does not. Instead what it offers is ...pilot programs."
Gawande goes on the recount the history of how the Agricultural Extension service did research, developed pilots to test the results, persuaded farmers to try the pilots, and sparked the agricultural revolution that so benefited the US economy in the first half of the 20th century. And he goes on to suggest that the many pilot programs for health care improvement proposed in the Senate bill could lead to a similar result and transform American health care.
His analysis is deeply flawed.