In a new essay entitled “Big Med,” physician-author Atul Gawande muses in The New Yorker if The Cheesecake Factory and other successful chain restaurants could serve as a model for improving health care. He wondered how a large restaurant could deliver “a range of services to millions of people at a reasonable cost and with a consistent level of quality,” while hospitals and other parts of the U.S. health care system can’t. The experience prompted Dr. Gawande to meet with managers, cooks, and other workers at a Boston-area Cheesecake Factory to see how it delivers good food and a good dining experience time after time. He then goes on to compare the restaurant’s procedures with what goes on in hospitals.
Today’s ruling by the Supreme Court that largely upholds the Patient Protection and Affordable Care Act should be viewed as a landmark event—whether one agrees with it or not. The Supreme Court’s ruling means that many more people will have health insurance; that health care will continue to be provided largely by the private sector; and that insurance companies won’t be able to deny an individual coverage because he or she has a chronic medical condition, drop coverage if an individual becomes sick, or put limits on the amount of lifetime coverage a person can get. It also means that individuals without health insurance will have to pay for it, and that many employers who do not currently offer health insurance as a benefit will be required to do so, or pay a stiff penalty.