Sunday, December 04, 2011

Basic Logic Fail

Okay, let's review.

This guy, Dr. D.M. Berwick, was appointed to head the US gov't office of Medicaid/Medicare.

He had a history of saying that we needed a health care system more like the Brit system, run by the government, and with rationing decisions made by bureaucrats. (Note: At KPC we understand health care has to be rationed. I just don't want it done by some person who got fired at the DMV).

Now, he says 30% of the US health care expenditures on Medicare/aid are pure waste, and doctors all know it.

He continues (I quote the NYTimes reporter's set-up)

If his estimate is right, Medicare and Medicaid could save $150 billion to $250 billion a year by eliminating waste, which he defines as “activities that don’t have any value.”

Dr. Berwick sounded like a professor of political science or a visitor from a foreign country when he recounted his efforts to fathom Washington’s ways.

“Government is more complex than I had realized,” he said in an understatement. “Government decisions result from the interactions of many internal stakeholders — different agencies and parts of government that, in many cases, have their own world views.”

Um.... so, I have a question. This guy was a big fan of government-run health care. He took a government job, and now he thinks 30% of the money we spend is wasted. He thinks government is "more complex" than he realized, and...well, the article continues:

Before coming here, Dr. Berwick was president of the Institute for Healthcare Improvement, a nonprofit group in Cambridge, Mass., that trains medical professionals. “I was used to moving very, very fast,” he said. “We could decide on Monday to start a program and have it in existence on Wednesday.”

As a federal official, Dr. Berwick was sometimes impatient with colleagues in the government and with the health care industry.

So, in this gentleman's OWN EXPERIENCE, private nonprofits are relatively fast and much more efficient and government sucks. Medicare/aid in particular is a disaster, as he knows from trying to fix it.

His solution: Let's expand Medicare until it's the entire health care system! He continues to love Obama-care like it's a religious pilgrimage.

Asked why Americans were still deeply divided over the new health care law, signed 20 months ago, Dr. Berwick said: “It’s a complex, complicated law. To explain it takes a while. To understand it takes an investment that I’m not sure the man or woman in the street wants to make or ought to make.”

But, Dr. Berwick said, just as Americans supported manned missions to the moon without knowing the details of rocket science, they ought to support the new law because of its ultimate destination.

A religious belief is one that you cling to in spite of all empirical evidence to the contrary. This guy saw, with his own expert eyes, the gigantic waste of time and money that is government-run, government-provided health care. He gave specifics, showed that he is actually a smart and honest guy.

And then reverts to his religious belief: worship the state, and the state will do the right thing. These little glitches....just aberrations. Eventually, he says:

“We are a nation headed for justice, for fairness and justice in access to care,” Dr. Berwick said. “We are a nation headed for much more healing and much safer care. There is a moon shot here. But somehow we have not put together that story in a way that’s compelling.”

No, doctor, there is a big difference between going to moon, and going to justice. When you get to the moon, you can come back. When you get to "justice," which you appear to be believe to be the absence of any private enterprise, you turn into Cuba. There is no coming back from that.


#1 Munger Fan said...

Does KPC disagree with this?

Anonymous said...

Interesting that the article Munger Fan's cited was published on It brings a quote to mind from someone Dr. Munger should be familiar with:

"The free man owns himself. He can damage himself with either eating or drinking; he can ruin himself with gambling. If he does he is certainly a damn fool, and he might possibly be a damned soul; but if he may not, he is not a free man any more than a dog."

Like The Freeman On Line says, health care does not have to be rationed any more than housing, food, transportation, etc. If health care is allowed to exist as it should, as true goods and services that people can freely exchange, people will by themselves decide when they've had enough. It is simply not true that people will insist on receiving any and all health care services they want if they have to pay for them out of their own pocket. The real problem now is that much too often someone else is paying for your health care.

Angus said...

Housing, food, transportation, etc. ARE rationed!!!

Anonymous said...

Even Cuba is not forever (you must have caught me in an optimistic mood), but point taken.