If We Built a Large Wooden Badger . . .

Monty Python fans fondly recall the scene from "The Holy Grail" in which Arthur and his knights build a large wooden rabbit to gain entry --Trojan-horse style--into a French castle. But Sir Bedivere, who is the mastermind of the plan, forgot to tell the knights the part about hiding out in the rabbit before the French took it inside the walls. Lying outside the castle, Bedivere reveals the part of the plan in which he, Galahad, and Lancelot leap out of the rabbit and take the French by surprise. The audience gets the problem a half second before Bedivere does. When he realizes he can't leap out of the rabbit when he's not IN the rabbit to begin with, he then suggests an alternative plan: "If we built a large, wooden badger . . . "

That scene came to mind when reading today's New York Times opinion section, in which David Leonhardt ponders "How can we learn to say no?" Americans use too much health care, he ponders, so how do we get them to stop?

The federal government is now starting to build the institutions that will try to reduce the soaring growth of health care costs. There will be a group to compare the effectiveness of different treatments, a so-called Medicare innovation center and a Medicare oversight board that can set payment rates.

Suspend your disbelief for a moment and take it as true that such institutions really will try to reduce the soaring growth of health care costs. Leonhardt goes on:

But all these groups will face the same basic problem. Deep down, Americans tend to believe that more care is better care.

That line illustrates the ultimate fallacy underlying Democrat health policy. Personally, I do not believe that Americans, deep down, believe that more care is better care.

And, in fact, neither does Leonhardt. He points out, later on in the piece:

When patients are given information about potential benefits and risks, they seem to choose less invasive care, on average, than doctors do, according to early studies. Some people, of course, decide that aggressive care is right for them -- like the cancer patient (and palliative care doctor) profiled in this newspaper a few days ago. They are willing to accept the risks and side effects that come with treatment. Many people, however, go the other way once they understand the trade-offs.

They decide the risk of incontinence and impotence isn’t worth the marginal chance of preventing prostate cancer. Or they choose cardiac drugs and lifestyle changes over stenting. Or they opt to skip the prenatal test to determine if their baby has Down syndrome. Or, in the toughest situation of all, they decide to leave an intensive care unit and enter a hospice. (Emphasis mine)

Wow. So thanks, Sir Bedivere, for pointing out after the fact that Americans don't really believe deep down that more care is better care. That our addiction to health care spending isn't really genetic or cultural. Rather, Americans appear to be hopelessly stuck in a system that rewards them for acting as if more care is better care. And that is a difference of colossal proportion.

Because to me it looks like we really don't need massively expensive new government institutions to begin making more rational decisions for us about health care spending. To me, it looks like what we need is for the decision to be more relevant to the patient.

But that's not the direction we've gone. Instead, we've herded millions more people INTO the system that rewards "spend 'til the end" behavior. Some reform.

But what about the badger? Leonhardt again:

So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform.

Take heed: how WE - - not you, not I, but "we" - - how WE can say no will be the most important task facing THE PEOPLE WHO WILL BE IN CHARGE OF CARRYING OUT REFORM. That's the mindset of the reformists - - WE in charge know better than the stupid unwashed masses about what's good for their health.

I am an American. I work, I pay my bills, I make decisions every day about what's worth spending my money on. I do NOT need a Washington bureaucrat deciding how "WE" can say no. I DO need the people in charge of carrying out reform to get out of the way and let a truly free market bring down health costs. That's what will help me the most.

The answer to the problem that government has created is NOT - - is NEVER - - more government.

And just to close the loop, remember that at the end of the "badger" scene, the French launch the rabbit out of the castle with a catapult. The rabbit lands on Gawains' page, who was having a hard time running away because he was so weighted down with luggage.

Extend the analogy as far as you wish. The royalty come up with "the plan," "the plan" fails miserably, ultimately backfires, and ends up killing the poor working stiff who was busting his balls for a living humping luggage for the royalty. The royalty, by the way, get safely away into the bushes.

Thanks, Sir Bedivere, but no thanks. Yours is a medieval logic that should be left in the past.