What's enlightening about this article, which purports to defend America's relatively free healthcare system, is not Donald Berwick's supposedly "radical agenda". Berwick is just another carbon copy of your standard socialist. It’s the free market “defenders” that raises eyebrows. Consider:
[Donald] Berwick "is a great fan of the [British] NHS" who "decries private sector solutions to health care problems, dismissing the “invisible hand of the market” as an “unaccountable system.” Unaccountable, that is, to government central planners. The “invisible hand of the market” refers to the voluntary decisions and actions of free, private individuals, who would become "accountable" to government bureaucrats under Berwick's vision. Yet, this obvious call for dictatorship goes unchallenged.
Robert Goldberg is quoted:
“Berwick complained the American health system runs in the ‘darkness of private enterprise,’ unlike Britain’s ‘politically accountable system.’ The NHS is ‘universal, accessible, excellent, and free at the point of care – a health system that is, at its core, like the world we wish we had: generous, hopeful, confident, joyous, and just’; America’s health system is ‘toxic,’ ‘fragmented,’ because of its dependence on consumer choice.
Goldberg answers Berwick’s charge about the ‘darkness of
private enterprise’ with: “It may not be joyous or just or configured
correctly, but…” No socialist could ever do as much damage to capitalism than this alleged defender who agrees that free markets are not "joyous or just". No amount of utilitarian support for free market healthcare could ever overcome the destructiveness of such a moral concession - and none ever has.
And Avik Roy finds a serious flaw – the First Amendment. “Berwick’s
approach only works if the narrow interests of Congressmen, labor
unions, general hospitals, the AARP, etc., have no influence on the
writing of law.” There’s a solution that would make Berwick happy.
Let’s eliminate “the right of the people peaceably to assemble, and to
petition the Government…”, and Berwick’s approach “works” just fine.
And Friedrich Hayek comes back to haunt: “the command approach is
doomed to fail because its commanders do not gain accurate information
about what is happening on the ground.” Well, Berwick would probably
say, that problem is now solved. Just give government access to
everyone’s health records electronically, and our powerful bean-
counting supercomputers will give our commanders all of the ground
info they need.
And the final Berwick quote in the article - “The decision is not
whether or not we will ration care. The decision is whether we will
ration with our eyes open.” - goes completely unchallenged
philosophically. In other words, the only choice is between efficient government rationing or archaic free market rationing, agree capitalism's defenders. The real choice, of course, is between Rationing and Freedom. But Berwick, the socialist who "simply believes that the single payer model is the most efficient, and the most easily managed, approach to health care", is simply allowed to get away with it.
Mr. Domenech claims that "Berwick is not particularly ideological". Oh, no? He lays out a consistently statist agenda that is based on fundamental premises such as his "accountability" and "rationing" positions that obliterate the distinction between the governmental and private spheres. Yet, Mr. Domenech offers no rebuttal, implying agreement at root with an avowed socialist.
If one wants an explanation as to why the past 75 years have been a steady progression to where we are now despite the best efforts of the free market Right- at the doorstep of a complete government takeover of American medicine - it's contained in condensed form right in this article. There is plenty of statistical and practical evidence presented here to prove that free markets work better that central planning. Our side has always had the factual proof, yet we continue to lose. Why?
Donald Berwick and his agenda will do tremendous damage to our healthcare. But, he will only be enabled by the accumulation of government power granted to him not only by Obama but by decades of growing government control of medicine. If not him, it would be somebody else. He is just a hitchhiker on a trend. The Right will never win the healthcare battle by conceding all of the basic moral, political, and philosophical premises of the Left.