Check out this 2 minute video of Dr. Donald Berwick, outgoing head of the CMS (Medicare, basically).  This video interview by the insufferable Dan Rather illustrates Hayek’s “fatal conceit” very succinctly and clearly.  Berwick laments the lack of a coherent “system.”  He says that parts of the health care “system” are the best in the world, but the overall “system” is flawed by virtue of its disorganization and lack of coordination.  

He says that the elderly woman with congestive heart failure and diabetes feels like a number, that the doctor doesn’t really know who she is and that the hospital doesn’t know what meds she is on.  Wow!  If only the government had more data and power!  What we could do for this woman!

Where does this lack of coordination come from?  Why does this woman feel so disenfranchised?  Why was the same woman 50 years ago the object of a caring and accountable personal physician?  What has changed?

The disastrous care the woman above will likely receive (if she can find any at all) is precisely the creation, the spawn, of men like Don Berwick.  The arrogant notion that a medical system can be managed from the top, down, is the dream of the statist planner, a wannabe tyrant, and the nightmare of those subject to this insanity.  Do you think there is any relationship between the “lack of coordination” of the system and the price controls and too numerous to list or comprehend rules and regulations that go along with Medicare?  Having had a hand in creating this maze and web, isn’t it insane for Berwick to decry its complexity and recalcitrance to “coordination?”

The new tyrant in charge of Medicare will be the same.  Just taking a job as head of CMS is indication that one subscribes to Hayek’s “fatal conceit.”  Meet the new boss, same as the old boss.  There is only one answer:  block grant Medicare to the states for them to unravel.  Any CMS head that advocates any solution to Medicare other than “fade back and punt,” as I’ve written before is infected with the same hubris that Don Berwick has shown.

Medicaid block grants are on the table.  Why not do it with Medicare, now, as well?  What a great opportunity to unwind this bankrupting mess.

G. Keith Smith, M.D.