Public policy on health care and the (non)-death of newspapers

Here are a couple of interesting pieces from the latest issue of The New Yorker:

[1] A must-read piece by Atul Gawande on how Obama should reform health care:

Yet wherever the prospect of universal health insurance has been considered, it has been widely attacked as a Bolshevik fantasy—a coercive system to be imposed upon people by benighted socialist master planners. People fear the unintended consequences of drastic change, the blunt force of government. However terrible the system may seem, we all know that it could be worse—especially for those who already have dependable coverage and access to good doctors and hospitals.

Many would-be reformers hold that “true” reform must simply override those fears. They believe that a new system will be far better for most people, and that those who would hang on to the old do so out of either lack of imagination or narrow self-interest. On the left, then, single-payer enthusiasts argue that the only coherent solution is to end private health insurance and replace it with a national insurance program. And, on the right, the free marketeers argue that the only coherent solution is to end public insurance and employer-controlled health benefits so that we can all buy our own coverage and put market forces to work.

Neither side can stand the other. But both reserve special contempt for the pragmatists, who would build around the mess we have. The country has this one chance, the idealist maintains, to sweep away our inhumane, wasteful patchwork system and replace it with something new and more rational. So we should prepare for a bold overhaul, just as every other Western democracy has. True reform requires transformation at a stroke. But is this really the way it has occurred in other countries? The answer is no. And the reality of how health reform has come about elsewhere is both surprising and instructive.

[2] Jill Lepore on the stories of the death of newspapers, and, more interestingly, on the history of newspapers themselves:

Newspapers date to the sixteenth century; they started as newsletters and news books, sometimes printed, sometimes copied by hand, and sent from one place to another, carrying word of trade and politics. The word “newspaper” didn’t enter the English language until the sixteen-sixties. Venetians sold news for a coin called a gazzetta. The Germans read Zeitungen; the French nouvelles; the English intelligencers. The London Gazette began in 1665. Its news was mostly old, foreign, and unreliable.

Because early newspapers tended to take aim at people in power, they were sometimes called “paper bullets.” Newspapers have long done battle with the church and the state while courting the market. This game can get dangerous. The first newspaper in the British American colonies, Publick Occurrences, printed in Boston in 1690, was shut down after just one issue for reporting, among other things, that the king of France had cuckolded his own son. Propping up power is, generally, a less dodgy proposition than defying it. The Boston News-Letter, “published by authority”—endorsed by ecclesiastics—lasted from 1704 till 1776. In 1719, two more Colonial papers began printing: the Boston Gazette and, out of Philadelphia, the American Weekly Mercury. (Nearly every early American newspaper was issued weekly; it took sixteen hours to set the type for a standard four-page paper.) But James Franklin’s New-England Courant, launched in 1721, in Boston, marks the real birth of the American newspaper. It was the first unlicensed paper in the colonies—published without authority—and, while it lasted, it was also, by far, the best. The Courant contained political essays, opinion, satire, and some word of goings on. Franklin was the first newspaperman in the world to report the results of a legislative vote count. The Boston News-Letter contained, besides the shipping news, tiresome government pronouncements, letters from Europe, and whatever smattering of local news was bland enough to pass the censor. Franklin had a different editorial policy: “I hereby invite all Men, who have Leisure, Inclination and Ability, to speak their Minds with Freedom, Sense and Moderation, and their Pieces shall be welcome to a Place in my Paper.”

Not long after Franklin started printing the Courant, he hired his little brother as an apprentice. Decades later, when an aging Benjamin Franklin wrote his autobiography, he painted his brother James as a brute, in order to make his own Hogarthian story, the apprentice’s progress, a metaphor for the colonists’ growing irritation with parliamentary rule. James’s “harsh and tyrannical Treatment,” Franklin wrote, had served as “a means of impressing me with that Aversion to arbitrary Power that has stuck to me thro’ my whole Life.” Franklin ran away. He might have titled this chapter of his autobiography “Wherein the Bridling Apprentice Pursues His Independence.” It is just the kind of story that clever people tell about their lives: meaningful, useful, and, quite possibly, not altogether true.

Have fun!

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