Donald Berwick, the late (as in former) temporary head (via recess appointment) of Medicare—the cowardly Democrats wouldn’t even hold hearings on his nomination because he supports rationing—makes the best case possible for Obamacare in the Washington Post. But it shows the law’s fatal and hubristic technocratic heart. From, “Putting Healthcare on the Right Track:”
Some people believe that the only way to address this problem is to shift costs to consumers. Obamacare has a far better approach: reduce health-care costs by providing better care and promoting better health. The law does this by targeting the underlying drivers of high health-care costs: It supports and rewards caregivers for preventing complications of care, like health-care-associated infections, which saves both lives and money. The CMS, for example, has set ambitious goals to reduce complications that, if met, would save 60,000 lives and $35?billion in just three years.
Wave the magic wand and promulgate the perfect regulation and it will be so!
Technocrats think they are so smart they can manage these things with centralized boards, manned and womanned by “experts,” who issue bureaucratic fiats, that makes the machine hum from the top, down. But the sector is too big and complicated for that. It won’t work.
It doesn’t work. The NHS, as I have repeatedly shown here, sets laudable goals that repeatedly aren’t met because bureaucrats can’t fix what’s broken by sending out memos. Meanwhile, people needing emergency care have had to wait for hours in ambulances to allow the ERs to appear as if they are getting to patients faster and women are giving birth in hospital hallways. Ditto, a story I posted the other day, about how Canada’s long waits for care and tests are mostly unameliorated despite the edicts and urgings of the technocrats.
But more is at stake than the smooth running of the American healthcare system. Despite their good intentions, reliance on technocrats constitutes a profound threat to freedom and accountability. Take the Independent Payment Advisory Board. As I wrote in the Weekly Standard, if allowed to stand, it will be a cornerstone of an unelected Bureaucratic State in which we are ruled by unaccountable experts—even over executive veto in IPAB’s case. We are already on that road already and Obamacare will make it much worse.
Brussels, of EU infamy, is the pattern. The governing power in the EU was intentionally removed from public accountability because the creators of the European Union thought the technocrats could bring economic prosperity and a birth-to-grave welfare union that would bank nationalistic passions and transform Europe into a new world power to challenge the USA and China. That’s really worked out well, hasn’t it? A technocracy w0n’t work any better in managing American healthcare.