Leonard Rodberg, research director of the N.Y. Metro chapter of PNHP, submitted the following letter to The New Yorker in response to Atul Gawande’s article titled “Getting there from here”:

Atul Gawande (1/26 issue) presents a convincing case that the paths that countries take into the future are strongly influenced by their history, especially their recent history. However, the path into the future is not uniquely determined but can take a number of different directions. In the case of health care reform, it is not obvious that employer-based private insurance provides the best or necessary direction that the U.S. should go. Another possible path, also drawing on our history, would expand the very successful Medicare program and the equally successful, though much-maligned, Medicaid program. Together, these two public programs account for nearly one-half of all health care expenditures today, while private insurance, which largely covers the healthy working population, accounts for barely a third of current spending.

So we can learn a number of different lessons from the past. What we should be asking is: which approach would provide better, more cost-efficient, sustainable health care for the American people. Expanding the wasteful, costly, and increasingly dysfunctional private insurance system will not provide us with the health care we need, while building on the very successful public programs can provide cost-effective, coordinated health care for all of us. That is the path we should take.