Health Reform in Historical Context

He mastered Arabic so he could talk to people unfiltered by others. No other reporter covered the region with as much depth of knowledge, cultural awareness, and historical context as Anthony Shadid.

Rick Gladstone, “Ex-Globe Reporter Dies in Syria”, Boston Globe, February 17, 2012

February 18, 2012 – When one writes about a long-drawn-out conflict, whether it is fighting in the Middle East or controversy over health reform in the United States, historical context is important. So are depth of knowledge, grasp of culture, and mastery of language. In health reform that language mixes bureaucratic , managed care, and medical jargon.

Shadid in Syria

When history, health care, and technology intersect, historical context becomes even more important. Anthony Shadid, a 43 year old year old, Oklahoma City born and bred American of Lebanese descent, two –time Pulitzer Prize winner, died at that intersection from a bout of asthma while reporting from inside Syria on a historic conflict sparked, in part, by the social media. His legacy will be a body of work, including his dispatches from the Middle East and three books, that put the Middle East in historical context. Shadid’s approach was to accumulate masses of revealing past and present detail to drive a narrative about ordinary people trapped in conflict.

J.D.Kleinke in the U.S.

On the health reform front, J.D. Kleinke is Anthony Shadid’s counterpart. Kleinke is a resident fellow at the American Enterprise Institute. He is a health care information entrepreneur, medical economist, business strategist, and reporter. He helped create four health care information organizations; served as a Wall Street Journal columnist, advised Democrats and Republicans on pragmatic approaches to health policy and legislation; and long advocated a data-driven, post-partisan health care system. Kleinke’s books include: Bleeding Edge: The Business of Health Care in the New Century Oxymorons: The Myth of a U.S. Health Care System, Catching Babies.


Kleinke’s latest WSJ article “The Myth of Runaway Health Spending,” dated February 17,2012, puts to rest the claim that government intervention is required to put the brakes on out-of-control spending.

Using CMS data, Kleinke shows health cost increase rates have been steadily moderating from 9.4% in 2002 to 3.9% in 2012, thanks to more effective generic drugs; positive changes in consumer behavior engendered by electronic information, pressure from various market disciplines, and transfer of health care responsibilities from government and corporate bureaucrats to consumers and their families.

Kleinke Position on Health Reform

Kleinke advocates a continuing transition to a market-driven system. He closes his article with these words.

“The decade-long trendline shows the way toward good policy for the future. If we really want to tame the health-care cost beast and make insurance "affordable," we would double down on all of the positive developments. “

“We would liberate people with their own money from layer upon layer of arcane, localized insurance rules. We would fix the tax code to uncouple health insurance from employment and let people purchase their own mix of services and coverage. And we would let them do so in a competitive, national market just like with auto insurance—instead of holding them hostage in fragmented, local markets while shaking down their employers to subsidize a system that wants desperately to change itself.”

Tweet: Historical context, cultural knowledge, and long-term trends are important when evaluating health reform and other conflicts.