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March 15, 2010




You've really framed the debate in very lucid terms: whether the changes needed in U.S. healthcare are systemic, and thereby necessarily deep and transformational reinvention, or whether we think an incremental effort at optimization will suffice.

Beyond idealogical differences, those two strategic views or approaches really do underscore how stark the choice before us is.

Sadly, the debate never settled on agreement for the kind of disruptive change needed, which froze public discourse into their current camps.

My hope is that if the current plan passes, Americans can then begin the real work: continuing to refine that start so that the process unfolding over the next decade can embrace the full breadth of process and technological innovations needed to increase the societal quality, while also addressing the overall costs, of a new model of healthcare.

Andrea Cotter

Thank you for an inspiring conversation opener. So many of your comments "hit home" with me. I too was part of both the Internet and Linux efforts at IBM. In each case, I recalled thinking what you stated...if only we could inspire people to "have faith" that we are on a journey and to embrace the change ahead of us together. I also find the comment about our tribal nature interesting. In expanding our aperature to think of ourselves as one, single tribe of humans on the planet Earth, I wonder if we would be less competitive and more able to embrace a change in healthcare that would benefit the entire globe. Sadly, as you say, it appears that leaders in Washington don't seem to think that there is a crisis looming. Regardless, I continue to have hope and like many others, I think that one incremental change at a time is better than no change at all in an entire year. There are many choices before us - its time to pick one and get started.

Chris Ward

You should come and look at what happens in the UK. It's not necessarily better --- the only certainties in life are death and taxes, just like in the USA --- but it is different.

Publically-funded supply of healthcare tends to lead to infinite demand. We don't spend our lives waiting in queues at the doctor's surgery, of course; we have other things to do (most of the time).

But it is handy to know that I will not be bankrupted, nor left to die on the pavement (sidewalk), if I get hit by a car when I leave my front door today.

Is it another consequence of me having a "King or Queen", and you living in a country that was founded on the desire to get away from "Kings and Queens" wielding power ? I suspect it might be.

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