Thursday, February 5, 2009

Annals of Public Policy: Getting There from Here: Reporting & Essays: The New Yorker

Annals of Public Policy: Getting There from Here: Reporting & Essays: The New Yorker:

"Social scientists have a name for this pattern of evolution based on past experience. They call it “path-dependence.” In the battles between Betamax and VHS video recorders, Mac and P.C. computers, the QWERTY typewriter keyboard and alternative designs, they found that small, early events played a far more critical role in the market outcome than did the question of which design was better. Paul Krugman received a Nobel Prize in Economics in part for showing that trade patterns and the geographic location of industrial production are also path-dependent. The first firms to get established in a given industry, he pointed out, attract suppliers, skilled labor, specialized financing, and physical infrastructure. This entrenches local advantages that lead other firms producing similar goods to set up business in the same area—even if prices, taxes, and competition are stiffer. “The long shadow cast by history over location is apparent at all scales, from the smallest to the largest—from the cluster of costume jewelry firms in Providence to the concentration of 60 million people in the Northeast Corridor,” Krugman wrote in 1991.
With path-dependent processes, the outcome is unpredictable at the start. Small, often random events early in the process are “remembered,” continuing to have influence later. And, as you go along, the range of future possibilities gets narrower. It becomes more and more unlikely that you can simply shift from one path to another, even if you are locked in on a path that has a lower payoff than an alternate one."

It's actually hard to get a representative paragraph out of this article. It is definitely worthwhile reading, as is everything Gawande writes, and begins with an overview of how universal healthcare took hold in England, France and Switzerland, and then makes the case for "path dependence", which starts the section I've quoted above.

Because I haven't written it in a while, Ill repeat a story. At a debate among single payer advocates and antagonists at
Duquesne University last year, I asked the representative of the very right wing Fraser institute of Canada, which of the world's nations systems he could live with us modeling ourselves after. Switzerland was the answer, and he conceded that the hybrid of using competing insurers and providers while requiring universal coverage with subsidies may be the second best solution for America. After laissez-faire capitalism, of course.

But it does make the point that the combination of path dependence and bits of common ground could lead us to real change.

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1 comment:

Anonymous said...

I AM SO ANGRY!

Tom Daschle, and Nancy Killefer are two of the finest, and most competent public servants you could possibly hope for in these appointments. They have been assassinated by the Washington healthcare lobby through their paid Bush Republican henchmen in congress. These Bush republicans are the same people blocking the economic recovery plan put forth by the Obama administration.

I am BURNING MAD America. And you should be too. Tome Daschle and Nancy Killefer were exactly what we needed to help turn this country around and fix our economy, and catastrophic healthcare crisis.

If I were their boss I would tell them to get right back to Washington. And dare congress to not approve them. How ridiculous is it to reject highly qualified people that this country needs just because they made a mistake on their taxes. Don't stand for that anymore America. They apologized, and paid their taxes, and that should be it. Their country needs them. But President Obama has to do what he thinks is best. I understand that. I'M JUST SO MAD at the anti American Bush Republicans.

Like many of you I have been trying to enjoy the after glow of this Beautiful historic election. But I see that the republicans in congress and their cohorts aren't going to be good sports, and LOSER'S!

SO BE IT!

In spite of President Obama's repeated offers, and gestures of collegiality to Republicans. Bush Republicans have seized upon every opportunity to stab President Obama in the back. And by doing so they are stabbing you, and the rest of the American people in the back. Well, you don't have to put up with that. And you shouldn't put up with that. President Obama has only been on the job two weeks. And he inherited two wars, and the worst economy since the great depression.

We had an election. And president Obama, and the democrats won BIG. And Bush Republicans lost miserably!

The Bush Republicans are the ones responsible for the worst economic crisis since the great depression. And the Bush Republicans are responsible for the worst healthcare crisis in American history. A healthcare crisis that is killing hundreds of thousands of you every year. Rich, middle class, and poor a like. Insured, and uninsured. Men, women, children, and babies.

President Obama, and the Democrats should take back all the concessions they granted the Bush Republicans, and tell them to put up! or shut up!

Everyone, start calling and contacting these Bush Republicans and tell them to stop blocking President Obama, and the Democrats recovery plan. And stop trying to block, and corrupt healthcare reform. Tell them to get on board with President Obama and the Democrats, or GET OUT!!

If these Bush Republicans refuse to cooperate I want all of you to immediately begin the process of removing them from office by every legal means possible. Including impeachment, and recall. I want you to bring the full weight and power of the movement down on their heads that swept President Obama, and the Democrats into control of the whitehouse, and congress. Take no prisoners. Use all the techniques you learned over this past historic election. Be flexible, creative, adaptable, and relentless like you were in the past.

To my cyber warriors I call on you again. You are among the best and the brightest. I call on you to move this fight from the cyber world to the living rooms, dens, and work places of the voters these Bush Republicans misrepresent. I know I can count on you. This is a fight worth fighting.

To my fellow World citizens. As an American I invite, and welcome you and your advise, input, and help. By delaying Americas recovery, and healthcare reform, these Bush Republicans are delaying our commitment to your recovery, and to being the better America for you that we aspire too.

I had hoped it would not come to this after our historic election. I had hoped that the Bush Republicans would respect the overpowering will of the people, and the World. But I guess not. All the Bush Republicans really care about is them-selves. Well, SO BE IT! Lets finish the job.

Sincerely

jacksmith --- Working Class :-)