From National Review Kevin Williamson writes McHealthcare Deluxe- The Affordable Care Act is a failed political product.
Emotionally mature people and highly effective institutions are quick to admit error. The best of them in fact embrace periodic failure as a necessary part of experimentation, learning, and institutional evolution. (Megan McArdle covers this ground brilliantly in The Up Side of Down.) McDonald’s, you may have noticed, rolls out a lot of new products, most of which do not end up staying on the menu. You cannot predict what products will succeed in a brutally competitive marketplace like the one McDonald’s plays in: That information cannot be calculated in advance — it can only be discovered. Discovery, not efficiency, is what competitive markets are really good at — organizing capital is secondary to the real function of free markets, which is organizing knowledge. But you can’t do that discovery work in the boardroom or in a laboratory: You have to go out into the pitiless real world and see what actually happens. Nobody walking the Earth knows as much about consumers’ soft-drink preferences than the beverage geniuses laboring away at the Coca-Cola Company, but they got it wrong big time with New Coke. The ACA was put together in part by some very smart people who have spent their lives studying health care and health insurance. It still stinks. They messed up.
The health care debates is so contentious because it focuses the differences in political and economic philosophies into a single issue. Does this require a central government solution or is it better served by solving it locally in the 50 laboratories we call states?
One of the greatest advantages of market solutions is not that it always picks better solutions, but that it recognizes failures quicker and better. The opposite happens in government. Self serving bureaucracies institutionalize failures. Instead of admitting failure and redeploying assets into better and different solutions we profess infallibility and increase the funding.
Trying to agree on component solutions is so arduous that we think that systemic solutions is the preferred path. But these solutions are so plagued with compromise that it has become impossible to make them effective. One side wants to build a bridge, the other side does not. We compromise by building half a bridge, spending 90% of the money and failing to provide the perceived need to cross the river.
The unwillingness to admit failure and implement corrective action is a big reason to be skeptical of expensive central solutions.