Policy

The Wit & Wisdom of Dr. Donald Berwick, Your New Medicare-Medicaid Jefe

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Paging Dr. Giggles!

Ladies and germs, meet your new bureaucratic head of Medicare and Medicaid, Dr. Donald Berwick, Harvard's latest train wreck of an appointee:

"Please don't put your faith in market forces," he said (italics in original).  "It's a popular idea: that Adam Smith's invisible hand would do a better job of designing care than leaders with plans can. I find little evidence that market forces relying on consumers choosing among an array of products, with competitors fighting it out, leads to the healthcare system you want and need. In the US, competition is a major reason for our duplicative, supply driven, fragmented care system."

Berwick argued that purposely provided an inadequate supply of health-care—as Britain's health-care system does—is superior to allowing the market to provide an excess.

"In America, the best predictor of cost is supply; the more we make, the more we use—hospi­tal 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 lit­tle of a technology or a service to too much; then you search for care bottlenecks and try to relieve them."

That's from a 2008 journal article praising Britain's NHS, the public-sector equivalent of K-Mart.

And there's this, too, which reads like a blurb on the Big Book of British Smiles or the tag line to the Nanny McPhee sequel:

"Cynics beware, I am romantic about the National Health Service; I love it. … The NHS is one of the astounding human endeavours of modern times."

More here.