The Same Fatal Flaw
“A pot owned by partners does not become cold, nor does it cook.”
This ancient Jewish aphorism found in the Talmud (Eruvin 3a) is discussing a situation of shared responsibility. The text is saying that when a pot is used by one person, it will be properly tended. But when utilized jointly by two or more people at once, it will neither be heated when such is necessary, nor chilled when that is desired -- the reason being that all of the users will assume that someone else will attend to the matter.
Accordingly, if the same job is given to both a single person and a group of four, the one person will likely get it done sooner, despite having one quarter the manpower. The group will be paralyzed by the dynamic of the “pot of partners.”
What is common to Medicare, ObamaCare, and the VA is that they are all run by government rather than for-profit private industry. By definition, government is a perfect example of “A pot of partners” -- something being run by more than one person. Think of it: who is in really charge of a government-run entity such as Medicare? If, for example, ongoing Medicare fraud was suddenly discovered in Omaha, Nebraska, who ultimately should rightly bear the blame?
The answer to this question literally boggles the mind. The ones really in charge of Medicare are: 1) the CMS (Centers for Medicare & Medicaid Services), the agency that actually runs Medicare, 2) the Department of Health and Human Services that oversees the CMS, 3) the OMB (Office of Management and Budget) that approved Omaha’s fraudulent funding requests, 4) the President of the United States who signed the funding bill allocating unnecessary money for Omaha, the respective Appropriations Committees of both 5) the U.S. Senate and 6) the U.S. House of Representatives that approved that amount for Omaha, 7) the entire Senate and 8) the entire House that voted those sums for Omaha into law.
A more dysfunctional “pot of partners” would be hard to find. According to the Talmud’s wisdom, if eight different authorities are simultaneously in charge of Medicare, it means that nobody is in charge! Hence, it is all but guaranteed that Medicare (or any other similarly managed entity) will be riddled with inefficiency, mismanagement, and fraud.
Since Medicare, ObamaCare, and the VA all deal with health care, the following numbers are most relevant and sobering. The facts speak for themselves.
Nobel laureate economist Milton Friedman wrote that between 1965, when Medicare and Medicaid were introduced, and 1989, the cost per patient day at a U.S. hospital increased eightfold. Since 1989, hospital stays have become yet far more expensive, and the cost continues to rise.
In 1966, Medicare cost the USA $3 billion. The House Ways and Means Committee then estimated that Medicare would cost around $12 billion by 1990, a figure that included an allowance for inflation. In 1990 Medicare ended up costing $107 billion, 900% higher than the 1966 estimate. The 2013 bill for Medicare was $500 billion. Some of the increases were due to newer and more expensive medical equipment and procedures. The fact however remains that the 2013 bill for Medicare was 4,100% more than the government once said Medicare would eventually cost in 1990.
The skyrocketing cost of healthcare since Medicare’s introduction in 1965 was not primarily due human malfeasance. Rather, the inescapable dynamic of “a pot of partners” assured from the outset that this program would wreak havoc on the affordability of U.S. healthcare. The psychodynamic that guaranteed this outcome is an unavoidable part of the human condition.
The notion that putting the right people in charge would have led to a different outcome is naive. It is like someone driving in a torrential downpour who thinks that turning on windshield wipers will assure 100% visibility. They providea split second of clarity after which the windshield is again obscured by the deluge. So too, the world’s best managers will make little difference in a government bureaucracy like Medicare whose major systemic flaws will always persist and cannot ever be repaired.
The same can be said for the VA. No matter how many of its managers resign and no matter who their replacements will be, there will always be many more VA scandals. For the VA to function acceptably, its functions mustbe turned over to private sector healthcare providers.
ObamaCare promises to become the biggest bureaucracy of them all. Consequently, unless repealed, it will utterly devastate U.S. healthcare – far more so than Medicare, Medicaid, or anything else.
May Heaven help us!