We are choking on technocracy, the belief by our betters in the ruling class that “experts” in government can plan and control virtually every aspect of society.
When these plans of mice and bureaucrats go awry, the technocrat’s response is always more technocracy, ever more complicated, unintelligible, and intrusive.
And now, with Obamacare collapsing of its own technocratic weight, true to the pattern, one of its prime architects, Ezekiel Emanuel, wants more regulations, more centralized control, more technocratitis.
Emanuel’s piece at Real Clear Politics on how to fix Obamacare is bureaucratic gobbledygook. Here’s just a brief sample. Just try to read it! From “Our Next Administration’s Health-Care Agenda,” written with Emily Gudbranson:
The next key reform should be aggressive payment restructuring coupled with requirements for physicians to assume more financial risk for their clinical judgments. To do so, the Centers for Medicare & Medicaid Services (CMS) should implement additional mandatory bundled payments in high-cost specialty areas, such as spine surgery, pneumonia care, and chronic obstructive pulmonary disease (COPD) exacerbations.
As bundled payment models have already shown savings and improved quality of care, they should be rapidly implemented nationwide under the ACA’s section 3023 authority. Savings can also be achieved if Medicare rapidly revokes many of the rules that currently allow stakeholders to game the system.
These reforms include reducing hospitals’ incentives to buy up physician practices, either by implementing site-neutral payments that eliminate the cost advantage to performing procedures in hospital outpatient facilities, or by reforming the 340B cancer drug program, which increases the margins on chemotherapy given at hospital-affiliated facilities.
Medicare should also — as it has already done with the new cardiac bundles — move to regional pricing.
Those two paragraphs alone (out of twenty) would probably add 1000 pages to the Federal Registry and 500 bureaucrats to the government payroll. Utterly insane.