[lbo-talk] Gawande on the USDA model of health care

brad bauerly bbauerly at gmail.com
Thu Dec 10 08:18:04 PST 2009



>
> 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.

Yes, but it obviously servers some purpose. Maybe it plays a role in creating and maintaining the dominance of US agriculture globally.


>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.)
Yeah, US productivity per unit land *increases* lag behind the average. It is simply that US ag started with much larger and more productive parcels of land, which goes back to the frontier land acts. On productivity per unit of labor power you are correct, no one comes close on rate or rate of increase. However, these two are not completely unconnected and it is the relationship between them that is important and how, again, the history of the development of US ag - with its large farms and lack of ag workers- that fed into the process of technological innovation. (the mechanical reaper is the real turning point in US ag).


>In short, this seems like a truly desperate, wrong and remarkably
>far-wandering maneuver to put lipstick on a pig.

Or, perhaps, it is an effort to maintain the US' dominant position in drug research and patents. Not that the view is entirely correct, but many fear the loss of this position if the large profits in the industry were removed. Thus, it is similar to the US' position in ag which is maintained by the influence of the state. It is often the case the progressive efforts for change result instead in policies that favor capital. Be careful what we wish for. Maybe no change is better than this type of change. If you can believe (in) it.

Brad



More information about the lbo-talk mailing list