Opinion

The Great Debate

Bill Gates is optimistic about the future

USA/The following is a post by Stephen Adler, editorial director of Thomson Reuters professional, that was taken from one of his blog posts at aif.thomsonreuters.com. Adler is a moderator at some of the panels at the Aspen Ideas Festival. Thomson Reuters is one of the underwriters of the event. The opinions expressed are Adler’s own.

Bill Gates, the former tech-nerd-genius, seems increasingly comfortable in his post-Microsoft role as philanthropist, humanist, and Big Thinker. Once awkward in public, he now speaks with warmth and authority about health policy, education, energy, and global innovation. His air of sincerity, hyperlinked to his extraordinary intellect, has turned him into a crowd favorite –- perhaps the crowd favorite –- at events such as the Aspen Ideas Festival.

In his hour onstage inside the giant Benedict Music Tent Thursday afternoon, before the largest audience I’ve seen at the Festival, Gates insisted he was optimistic about the future. He got a big laugh by adding the caveat that to stay optimistic you have to “avoid getting exposed to U.S. politics.” In particular, he cited enormous improvements in healthcare, education, and women’s rights over the past 50 years. The most startling statistic: Deaths of children under five declined globally from 20 million in 1960 to 8 million last year, mostly due to vaccines and better malaria prevention and treatment.

But Gates tempered his optimism with a catalog of obstacles to the kind of changes he seeks, especially in the U.S. In education, healthcare, and energy policy, we have created perverse incentives that lead us away from the results we all seem to want. We fight immigration, even though it brings us some of our best innovators and “lots of I.Q. points.” We refuse to measure teachers’ performance intelligently and encourage improvement, even though we understand that great teaching is the key to learning and achievement. We raise the cost of public university education in response to the financial crisis, even though our higher-education system is one of our nation’s greatest economic assets.

In health care, we spend more than other wealthy nations and get back so much less. This is mostly because we provide incentives to keep people sick so the medical system can keep treating and charging them, rather than shifting the incentives to keeping people well. In energy, we bemoan our dependence on foreign oil and our contribution to global warming while refusing to put an appropriate price on carbon use or invest enough in research on alternative sources.

from Commentaries:

The mirage of U.S. healthcare

On healthcare, the White House is struggling with a political riptide that threatens to drag it into deep water.

Americans, as they contemplate change, have suffered a weakness of nerve. The main reason is that nearly two thirds of Americans are apparently happy with their healthcare coverage, for all its deficiencies. Repeated reassurances from President Obama that those who like the existing set-up will not be forced to change, have had little effect.

A change of tactics may be in order. The administration must do a better job of underlining the glaring defects of the existing system. The genius of the U.S. healthcare is in providing the illusion of value and security. For their own sake, Americans must be encouraged to set aside jingoistic claims about having the best care system in the world and look more honestly at its short-comings.

Let's start with value. Most Americans are blissfully unaware that their healthcare system provides appallingly little value for their money. This is because when it comes to costs, they see only the tip of the iceberg. While companies typically pay about three-quarters of an employee's family premium -- on average $12,680 a year -- individuals ultimately bear the burden. In a free market, companies do not hand over to their workers more than they absolutely have to. Money spent on healthcare is carved out of take-home pay or other benefits.

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