This can probably be filed away as just another sign that the times they are a changing, but it’s still a very remarkable lead for a newspaper story:
President Obama recently summoned aides to the Oval Office to discuss a magazine article investigating why the border town of McAllen, Tex., was the country’s most expensive place for health care. The article became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.
“He came into the meeting with that article having affected his thinking dramatically,” said Senator Ron Wyden, Democrat of Oregon. “He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we’ve got to fix.’ ”
The magazine article in question was Atul Gawande’s fascinating look at Medicare costs in the June 1st issue of The New Yorker. (The fact that the word “fascinating” can be legitimately used to describe anything to do with Medicare speaks to the high quality of the article.) In it, Gawande spends a lot of time in south Texas trying to figure out why cities which are geographically, demographically and economically similar have wildly different Medicare costs. The two primary examples he cites are El Paso, where costs are about the national average, and McAllen where costs are double those in El Paso. As recently as 1992 costs in each city were roughly equal, so it isn’t a case of El Paso doing something radically different to control costs along the border, it’s a case of something fundamental changing in McAllen.
The article’s conclusions are both encouraging and disheartening when it comes to health care reform, and they can’t really be summarized here. (In other words: it’s worth reading in full.) What’s interesting about this incident isn’t that The New Yorker had a long and thoughtful article that gleaned new information about a prominent topic of public interest. That happens all the time. Rather, what’s interesting here is that the President of the United States acquired information he found to be useful not from some government report or think tank white paper. He got it from a mass market magazine. This is the very definition of “outside the bubble”.
The contrast with the Bush Administration is obviously very stark. (Would it surprise anyone if URLs like www.newyorker.com were blocked with filtering software during their tenure?) Amongst its many problems, that Administration was notorious for ignoring information it did not want to hear. The apotheosis of this is probably the White House staff’s decision to make a DVD of gut wrenching news footage to get Bush the Younger to realize disaster was unfolding in New Orleans. The Gawande article isn’t all doom and gloom, but it’s no walk in the park either. It presents some very grim realities and some very sobering facts for anyone intent on changing health care policy.
There’s no knowing how Obama became aware of the article, perhaps he’s a regular New Yorker reader, perhaps someone with his secret e-mail address recommended it to him. It doesn’t matter. In the grand scheme of things this particular instance isn’t likely to matter much either. What does matter is that even though he sits in the middle of the bubble, Obama found a piece of outside information he found useful. It speaks well of the way the new President has organized his very complicated work life.
