When Mitt Romney and other critics of the Affordable Care Act say that Americans don’t need or want a “one-size fits all” health-care system, they make a specious complaint. The ACA maintains the current hodgepodge of private-sector insurers and health-care systems and is a far cry from centralized medicine.
More significantly, the complaint ignores the fact that a one-size-fits-all health-care system would probably be a big improvement on what we have now.
Dr. Atul Gawande makes that argument in a fascinating article contrasting how health care is delivered with how the Cheesecake Factory, a popular restaurant chain, delivers high-quality food to millions at reasonable prices while regularly making innovations and training staff to adhere to new standards. Gawande takes readers into the CF’s standardized kitchen and into chef training sessions to show how every step of the business is managed and evaluated for efficiency and customer satisfaction.
Granted, providing heath care is different from serving up plates of miso salmon. Gawande’s point is that unlike the big chain operations such as the Cheesecake Factory, Walmart or Pizza Hut, most hospitals and clinics operate with no one in charge and no sense of what best practices are to be enforced. The result, Gawande says, is that Americans get from their doctors and nurses “greasy spoon fare at four-star prices.”