Atul Gawande in the New Yorker: The problem with medical care in this country is how to control costs. The Congressional plans fail in doing that, so they are not real reform.

But Gawande compares health care today with problems in agriculture at the turn of the 20th century. This is a fascinating insight. I have not read it all yet, but so far I like it. He points out some interesting parallels: small, inefficient units that lacked productivity, they were of course too labor intensive, and more.

At the start of the twentieth century, another indispensable but unmanageably costly sector was strangling the country: agriculture. In 1900, more than forty per cent of a family’s income went to paying for food. At the same time, farming was hugely labor-intensive, tying up almost half the American workforce. We were, partly as a result, still a poor nation. Only by improving the productivity of farming could we raise our standard of living and emerge as an industrial power. We had to reduce food costs, so that families could spend money on other goods, and resources could flow to other economic sectors. And we had to make farming less labor-dependent, so that more of the population could enter non-farming occupations and support economic growth and development.

It's long, but read it all.