Solutions for great and complex societal problems are rare. There’s no guarantee that local successes can be replicated. But our best strategy is to look for ideas that work on a small scale and try to figure out how to make them work on a larger one. The right spirit is empirical: try things out, learn what you can, adjust, and try again. There are no foregone conclusions—except that we’ll fail if we don’t even try. [More here]
No, Dr. Atual Gawande was not speaking to Ms. Aruna Roy or Harsh Mander or the National Advisory Council of the UPA Government in India. He was talking about a small experiment in some parts of the US where they are targeting very sick patients (5% of the total patients) who account for 60% of the total healthcare costs. They are finding out that it is helping keeping costs down, care up (reduced hospitalization and improved health). Read the whole thing here. What one likes about Dr. Gawande is he is no ideologue. The last paragraph that I have pasted above confirms that.
That is the spirit that India needs now.
In fact, I made the effort to read his original, long article on medical hotspotting. You can see the full article here. It is absolutely fascinating and brilliant stuff. There are so many dimensions to the story that business school professors, social scientists, academics and practitioners in public policy, students of political economy, etc., must simply lap it up and spend half a day to a full day discussing all its dimensions. From sheer persistence, to holistic thinking, to plugging away, to anticipating political resistance – there is everything in the story.
If you had not yet read ‘Complications’, pl. do so. I have bought ‘Checklist manifesto’ and I am yet to read it. Embarrassed to say so.
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