Surgeon Gawande Seeks More ‘Rational Care’ in Medicine

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• JIM LEHRER:

  Now another in our conversation series on health reform, and to Ray Suarez.

• RAY SUAREZ:

  Some of our previous conversations have gauged the views of a hospital executive, the CEO of a major insurer, and advocates from both sides.

  Tonight, we speak with a cancer surgeon and well-known writer whose essays and reports have influenced the debate. Dr. Atul Gawande directs the Center for Surgery and Public Health at Brigham and Women's Hospital in Boston. He is also a staff writer at The New Yorker.

  And, Doctor, the president is going bat himself before a joint session of Congress to stump for health care reform next week. Congress is returning to work. When final versions of these bills are finally circulated in the House and Senate, what for you is the make or break? What has to be in those proposals?

• DR. ATUL GAWANDE:

  Well, first of all, what I would want to see is that there are final versions in the House and Senate.

  My — my great fear here is that nothing will come through. The debate has become so torn that we're losing sight of the fact that we do have some central problems we have to fix for our country, both people who are losing insurance or have insurance that doesn't cover basic needs, and then our struggles with the cost of the system.

  And I think that's what's got to be there, is an effort to really make a lifeboat that covers people when they lose coverage, gets rid of preexisting condition exclusions for their coverage, and then also begins making the deposit of working on the — the deep, hard problem of our costs.

• RAY SUAREZ:

  Congress went on recess, and the version of a national conversation began. What's been missing in that? What important conversations haven't been included in the debate thus far?