Random Cruelty
After reading Nick Gillespie’s oh-so-apt description of Medical Maladjuster Majordomo Dr. Donald Berwick as “Harvard’s latest train wreck of an appointee,” I was overcome by a cruel idea. It goes a little like this: Why not make forbid any and all Ivy League grads from taking government jobs, elected or appointed?
But then, of course, you have to ask yourself, “What did the private sector ever do to deserve this?”
So how about something slightly different: Ivy League grads will be permitted only to work for –wait for it– Ivy League institutions? Sure, there’s not much room for advancement, but with those massive endowments, they have plenty of wealth to spread around. And that’s good for everybody, right?
Anyway, just something to think about while I work on making some radio and TV and stuff today.
UPDATE: I just now got around to reading the actual article Nick quoted, and get this bit:
“In America, the best predictor of cost is supply; the more we make, the more we use—hospi tal beds, consultancy services, procedures, diagnostic tests,” Dr. Berwick wrote. “… Here, you choose a harder path. You plan the supply; you aim a bit low; you prefer slightly too lit tle of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”
That’s right — the way to reduce prices is to –wait for it, one more time– decrease supply!
It must take a major IQ and a Harvard degree to wrap your brain around that one.
Presumably Dr Berwick is an intelligent and (at least at one time) competent fellow. Is he perhaps an example, a la Thad Allen, of WeWon’s decompetence-inator effect?
It’s perfectly fine for undergraduates to test out new thoughts, and reject conventional wisdom. But by the time they graduate, they should have tested conventional wisdom and found that it’s called wisdom for a reason.
“you prefer slightly too little of a technology or a service to too much;”
So are you going to create a panel to determine who gets the service, and lives, and who doesn’t get the service and dies?
Here’s a thought experiment for everyone, after reading RBJ’s comment above.
What might be a good name for these panels empowered to decide who does and who doesn’t get lifesaving medical treatment?
Hmmmm…?
And no fair peeking at Facebook for the answer!
Instead of directly prohibiting Ivy League grads from government jobs, how about prohibiting anyone who does not have at least 10 years of real-world work experience? No one should be allowed a government job unless they’ve held a private sector job outside of academia. Academia is a warped mirror of the real world. That’s why you still have academics who believe in communism and socialism. In the false world of academia, there is little impact for failed ideas or stupid policies. The real world does not have tenure for good reason.
Orwell was right: there are some things so stupid that only an “intellectual” could believe them. Someone at some point told these Ivy Leaguers that they were the best and brightest and they actually believed it.
In Heinlein’s ‘Starship Troopers’ the majority of voters earned their franchise as career civil servants, the
rest as members of the military, and _none_ of them
could vote until they had completed their service;
Government by the responsible minority.
“Instead of directly prohibiting Ivy League grads from government jobs, how about prohibiting anyone who does not have at least 10 years of real-world work experience? No one should be allowed a government job unless they’ve held a private sector job outside of academia.”
The problem with this is that you’ll only end up with government employees that are unable to compete in the real world- much like the average Ivy-league-coddled academic. If they’re successful in the private sector, why bother with a government job at all?
I’ve always thought that the only people that should have government jobs, police duties, or indeed any job with the weight of enforcement behind it should be those with no desire to do it but with sufficient sense of duty to perform their task diligently. Assuming a large enough pool of such people could be gathered (good luck with that) and term limits for all government jobs could be agreed upon, responsibility could quite possibly return to government. Think about it: the sort of person that desires the power of government is the exact person that shouldn’t wield such power.
It makes sense, he’s just misusing his terms.
Sounds to me like he wants to manufacture a supply glut. He talks about reducing supply, but really he means demand. Government will insert itself in between health care suppliers and health care consumers. So when he talks about aiming a bit low on supply–he means the supply to us. To the suppliers, he means demand. Government will only buy just so much service and equipment.
The resulting oversupply will cause prices will drop, potentially below cost of production. It will save lots of money, at least until suppliers start going bankrupt and supply readjusts to the government’s demand.
Then we will need to reduce services more to keep the supply glut going to protect the savings. Eventually we won’t have health care at all, and then think how much money we’ll save!! (Yes, I’m being facetious. Far too many administrators will be making far too much money for them to really roll back costs.)
You are too kind; He means to say that the demand
for a free good is infinite, but even State funds
are not.
Cost and price aren’t the same thing.
Berwick was talking about reducing cost, not price. Cost is price x quantity.
So, yeah, you can reduce the cost of a product by reducing supply. For example, if there are no bypass surgeries anymore, then the cost of bypass surgeries will be $0.
An economist told me that only 20% of the healthcare cost increase in the US in recent years is due to price inflation. The other 80% has been due to increased consumption of healthcare goods and services.
Note that nobody has ever suggested that Obamacare will lower the price of healthcare, just the cost.