Darwinian Health Care, or How the Government Should Kull the Herd

Consider how the Government typically sets up and manages one of their programs. They either create the agency that will administer and operate the program or they establish a regulatory body that will oversee the operation of the program across the industries that provide the products and services of interest.

In the former case, the Government creates the team of experts and professionals that are responsible for delivering the products/services required of the program. The long-term destructive motivator contained within this approach is that the agency becomes oriented toward increasing their scope of responsibility, their staff and their budgets. They lack any basic economic feedback control mechanism that motivates the agency to seek more efficient, effective, innovative, and economical methods of operations or for superior and higher quality deliverables and satisfied clients. Over time the bureaucracy evolves and morphs into a self-serving and administratively heavy organization that could not compete against a public sector organization that would have to function strictly upon a profit-motivated operation.

The latter case: regulatory bodies, are (incredible as it may be to imagine) even more ineffective, inefficient, stodgy, and uneconomical than the Government agencies manage to become. They will have either a head or board that contemplates what will be the best way for the public, commercial or industrial sectors under their sway to operate in order to satisfy the inspired visions of their lords and masters: Congress. But once again, the regulatory bodies have no reality-based, real world economic dynamics that affect their decisions, policies and actions. In other words, they are disconnected from reality or accountability. The consequences of their actions are not their responsibility, and the most likely outcome of their failures and incompetencies is the expansion of their budgets and scope of interference. Thus, they grow if they waste your money, and are rewarded with more funding if they screw-up.

How then is the Health Care Reform bill to accomplish one of its major goals: to make health care more affordable? If we rely on the Government’s standard methods, we will literally be killing people by destroying the system that keeps some of them alive today.

The answer is to learn from the past, from our history, our experiences, and from our founding principles that individuals should be free to pursue their own interests. In a more explicit and direct explanation; the Government must create not one agency or regulatory body to oversee and execute their Health Care system, it must create at least two. Three would be better.

The rationale for multiple entities is to establish one single and overriding principle that guides these organizations: Competition. The different organizations would be charged to delivery on the goals and objectives of the Health Care Reform act, and they will be rewarded based on their competitive success in achieving those goals at the lowest costs and the best quality with the highest success rates. Inserting this competitive factor into their operational environments creates the equivalent capitalistic motivation that the private, commercial and industrial markets contend with every day; and which either rewards them for their successes or culls them from the herd for their failures.

This competitive principle will provide Darwinian opportunities for these organizations to choose among every day. The organizations that select wisely will be able to leverage the wisdom of their decisions into both more rewarding compensations, and into a longer guarantee of continuity. Those organizations that fail will be neither rewarded in benefits nor in continued existence. In effect, the Government organizations will bred true to their purpose, or die; a Darwinian evolution of health care that will improve the quality of care at ever more efficient costs. The principles of competition will provide an American Health Care system which the rest of the world will continue to point to as the example for all to achieve.