The Power of Pilot Programs

The always-enlightening Atul Gawande evaluates the new health-care bill’s efforts (or lack thereof) to control runaway health-care costs. The bill, which has been widely criticized for its lack of significant cost reductions, proposes a few small pilot programs aimed at cost containment. As Gawande writes: “[W]here 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.” He goes on to compare health care reform to the agricultural reform that transformed the nation (and the world) in the early 1900’s and was implemented piecemeal in a series of small experimental programs. Gawande concludes on a hopeful note: “[I]f we’re willing to accept an arduous, messy, and continuous process we can come to grips with a problem even of this immensity. We’ve done it before.” [%comments]