Posted by lex, on July 19, 2010
Donald Berwick has been appointed to oversee the nation’s health care in his position as director of the Centers for Medicare and Medicaid Services. The appointment was made when the Senate was out of session, thereby obviating the need for Dr. Berwick to explain his thoughts on managing, directly or indirectly, twelve percent of the nation’s GDP.
Which is a shame, because there is much fertile earth to till:
“Please don’t put your faith in market forces. It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can.”
“Indeed, the Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs.”
“It may therefore be necessary to set a legislative target for the growth of spending at 1.5 percentage points below currently projected increases and to grant the federal government the authority to reduce updates in Medicare fees if the target is exceeded.”
“About 8% of GDP is plenty for ‘best known’ care.”
“A progressive policy regime will control and rationalize financing—control supply.”
There’s more, and – who knows? – much of it may well be true. But the good doctor is charmingly assured that a Few Smart People can better make choices for everyone better than each of them can make for themselves.
Markets clearly can make mistakes. Market psychology can swing to psychosis, but it’s usually self-correcting.
It’s very rare to see government admit to error, even those composed of “leaders with plans” who intend to reduce the nation’s expenditure on health care by 33% while extending it to everyone.
I would have liked to hear the doctor explain that plan.