Atul Gawande (one of the White House's idols when it comes to thinking about health care) seems to think that the US system of agricultural support payments is a model our health care system should try to emulate:
http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande?currentPage=all
And he argues that the fact that it was built in piece meal fashion from inauspicious beginnings should make us sanguine about this awful dog's breakfast they are now thinking of passing as health reform.
In the first place, the idea that the US system of agricultural support payments is a model that our health care system should aspire to seems beyond batty. I thought virtually everyone agreed that it massively wastes money, incentivizes perverse and unhealthy outcomes, and is nearly impossible to change because of the tightly woven web of interests that surround it like chain mail armor. Which, come to think of it, sounds exactly like the health care system we've already got!
And then on top of that, this seems like a very suspect history of American agriculture. To start with, Gawande seems to confuse productivity per unit land (which American agriculture was always bad at, and still is) with productivity per unit labor power, which IIUC American agriculture was always historically good at. Similarly (and relatedly) his assertion about how American farmers were to resistant to innovation seem wrong. IIRC American farmers were historically known for precisely thid willingness as early as the early 19C century where they pioneered in mechanization. (The cotton gin changed the course of history.)
Similarly he seems to confuse a crisis for producers -- when prices go down -- with a crisis for consumers -- which is exactly the opposite. IIUC, we had the first in the 1920s, when excess capacity ginned up for WWI export and bought with debt was still there when the war was over. And this is when he starts his narrative, as if this was a crisis for consumers. People started leaving the land in droves because they couldn't make a living at it.
So if I'm right, Gawande seems not to know up from down when it comes to agriculture, which doesn't bode well for his analogy. And everything else about his account seems weird and distorted as well in re the famous people and events he leaves out and the obscure ones he highlights.
In short, this seems like a truly desparate, wrong and remarkably far-wandering maneuver to put lipstick on a pig.
But I'm no expert on agricultural economics or history. So if my impressions are way off, please correct them, I'm all ears.
Michael