As part of its excoriation of ObamaCare and the bureaucracy created thereunder, the Wall Street Journal had this to say about a “reform”:
Dr. Gawande’s point is that medicine would function better if care were delivered by huge health systems that can achieve economies of scale, like commercial kitchens. Care ought to be standardized like preparing a side of beef, with a “single default way” to perform each treatment supposedly based on evidence, with little room for personalization.
No doubt health care could learn a lot about efficiency from a lot of industries, but to understand the core problem with assembly-line medicine, recall that ObamaCare actively promotes medical corporatism. The reason isn’t to encourage business efficiency but for political control. Liberals believe in health-care consolidation because fewer giant corporations are easier for Mr. Orszag’s central committee to control, and more amenable to its orders.
For those who know me IRL, I’m no stranger to the medical system. Some of the problem with ObamaCare is corporatism; a larger problem is that much of medicine is an art, not an assembly line. Back when I was 19, I had a large mass in my breast; ultrasounds and a biopsy were inconclusive. (The result of the biopsy was that it had “abnormal architecture.”) My doctor suggested removing it; the other option was yearly biopsies until a huge problem developed.
Pray tell, how does “unknown cellular structure with abnormal architecture” fit in under a “single default way” to “treat”? Let’s ignore the glaring problem that few nineteen-year-old women will get treatment for breast abnormalities under ObamaCare; instead, focus on how on earth some bureaucrat could make that decision.
Back in the day, the Soviet Union set prices for goods – twenty-four million prices, to be exact. Those in charge of delivering the standards of care will have to account for an infinite number of permutations of age, health history, family history, current health status, and the situation I had, in which diagnosis and treatment could not be disentangled (i.e. my doctor figured out what it was when she removed it from my body and sent the tumor to a pathology lab). We will either have twenty-four million different standards for treatment, or standards that do not encompass the particular condition of the patient.
If you thought that having some green-thumbed kid at an insurance company dictate your medical care was bad, just wait until those “decisions” are made via a bureaucrat’s spreadsheet.