What Medicare’s Payment Woes Tell Us About the Limits of Technocratic Reforms
28th December 2016
On consistent lesson from these failures is that it’s as important to make the politics work is as important as getting the particulars of the policy right. A well-designed policy that is likely to fail politically is not a well-designed policy. Often the two are at odds.
Another is that it is better to avoid entangling complex and vital systems—like, say, the health care sector—with politics in the first place. Because we are now in a situation in which we have a health care system that weighs down both the federal government and the private sector, a system which nearly everyone agrees is inefficient and unsustainable in its current form, but which, despite the efforts of reformers, also consistently and frustratingly refuses to be reformed.
A perennial problem when attempting to take money from one class of people (e.g. taxpayers) and use it to provide a benefit for another class of people (e.g. influential voting blocks) is that choices are made on political grounds rather than on economic grounds; this way leads to inefficiencies, as always happens when people try to substitute politics for economics.