Two concepts from an unsigned editorial in today’s Providence Journal beg for juxtaposition. It’s about a proposed Care New England and Southcoast Health System merger. First:
To be sure, regulators should carefully weigh what the new organization’s market share is apt to be in any number of areas, from primary and obstetrical care to cardiac facilities. How would the proposed merger affect Lifespan, currently Rhode Island’s largest hospital system, and presumably its chief competitor? How would it affect smaller entities such as the still independent South County Hospital?
The changes under way in health care are complex, and at times seemingly beyond the grasp of even health-care experts.
The whole editorial treats the merger as if it’s a question of public policy about government agencies, rather than the operation of private organizations. I find myself wondering, once again, what long-running government program instills the Providence Journal editorial board with such confidence in regulators’ ability to behave as an executive board for an industry that seems “beyond the grasp of even health-care experts.”
That shouldn’t be a new question. It’s a basic, long-standing part of the intellectual economic discussion whether human beings can possibly collect and process enough information to make economic decisions on anything but the most narrow, direct, and personal questions. Another basic consideration in the economic discussion is that the more decision-makers are insulated from consequences, the less care they’ll take and the less competence they’ll display. Giving “regulators” and the general public (as represented, here, by a newspaper editorial board) power to make economic decisions for both the providers and consumers of health care is many steps too far.
With Rhode Island as an excellent case study, the United States of America needs to get out of the weeds of private industry and turn its attention to the harder questions of social belief and policy. It’s a lot easier superficially to decree that everybody should have access to “quality, affordable health care” and then push the blame for failure around to interested parties and supposed experts than it is to answer the deep questions — especially when the solution for that failure is always to give the interested parties and supposed experts more power.
The deep questions to which I refer are those such as: What level of health care is “a right”? How does that right interact with individuals’ personal responsibility? Who pays for that level of health care? Who gets to balance that cost against other possible uses of scarce resources?
Simplistic declarations about rights, with the responsibilities handed off to unaccountable bureaucrats, absolve individuals and communities of responsibility. This lesson has become too obvious to miss in a country whose elite president indulges in endless rounds of golf and multi-million-dollar family vacations while education insiders prattle about needing more money for their own special interests and editorial boards blithely hand our freedoms over to Ubermensch regulators.