Article

There was an article in the New Yorker last week about health care reform in the USA that used the concept of path-dependency to argue for an improvement of existing policies rather than a complete overhaul of the system. It's a very valuable point, especially considering that a complete overhaul could lead to temporary disruption until the new institutions start working properly; and because we are talking about health care, any disruption, even if it is temporary, would literally kill people. On the other hand if the system is dysfunctional it is difficult to argue for simple improvements. Therefore what could be a good solution is to establish a long-term goal of deep reform that would be achieved by small incremental steps, built on the existing path-dependencies. It would still be necessary to respect the US context but on the other hand it would attempt to resolve the fragmentation that leads to such high costs.