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Health-care reform will resemble the evolution of browsers + HTML: both are path-dependent
- paulsmith 18y agoI thought this piece by Atul Gawande on how health-care reform in the U.S. will proceed was illuminating. He uses the social science term "path-dependent" to describe systems that grow up around early design decisions, and they win out over alternatives that purport to be better (for some definition of "better") because those very decisions turn out to be far more consequential than could have been foreseen at the time. He argues our new health system will build on the existing one, and not be a from-scratch replacement, because of path-dependence, and give examples of how other industrialized national health plans follow this dictum. I thought of the co-evolution of Web browsers and HTML, and the current efforts to create a successor to HTML 4, while reading the article, and noted the similarity. HTML 5 is expressly designed to "pave the cow-paths" of the way HTML 4 is actually used and implemented by browsers.