Gawande: Senate bill’s lack of ‘master plan’ may be best strategy

Surgeon and influential essayist Atul Gawande contends that the Senate bill’s piecemeal approach—and specifically, its reliance on pilot programs—may be the necessary solution for the nation’s fragmented health system.

In the Dec. 14 New Yorker, Gawande compares the current U.S. health care system—which accounts for 18% of national spending—to the country’s agricultural sector in the early 20th century, when 40% of a family’s income was dedicated to purchasing food and roughly 50% of the labor force was devoted to farming. Gawande outlines some farm program pilots to the pilot approach used in the Senate bill.

(SOURCES: Advisory Board Daily Briefing,, December 9, 2009; The New Yorker,, accessed December 22, 2009)