Jewish World Review Jan. 25, 2011 / 20 Shevat, 5771
The HealthStat Seduction
By Jonah Goldberg
If professional writing were the guild it often appears to be,
His latest article, "The Hot Spotters," focuses on what Gawande claims is a revolutionary approach to health care. In
Another fellow, weighing 560 pounds, with both an alcohol and cocaine problem, spent more time over a three-year period in the hospital than out of it. But thanks to work by a crusading doctor,
Brenner's theory is that we can save billions by delivering better health care to the sickest people. Brenner was inspired by the CompStat approach used by police in
Brenner's results are impressive. All it takes is a near-religious dedication to getting involved in the nitty-gritty of patients' lives.
In a similar effort, a clinic formed by
Gawande recounts how one such coach -- a former
"Because she talks like my mother."
A preliminary study found that the
Still, Gawande's enthusiasm is infectious, and so is the passion of professionals like Brenner. Where Gawande falls short is in explaining how all of this justifies "ObamaCare" (apparently he hasn't gotten the memo about not using that term).
Yes, the Patient Protection and Affordable Care Act funds pilot programs like Brenner's, but it also fuels the sort of bureaucracy that even Gawande and Brenner concede strangles innovation. It makes insurance companies into even more sheltered monopolies -- health utilities, in effect -- and appeases many of the political constituencies that stand to lose money from this style of counterinsurgency medicine.
Also, we know that ObamaCare incentivizes corporations to dump their most expensive patients onto public exchanges. Which means taxpayers will pick up a much bigger tab than we were told.
Given these disappointments with the latest cures for the system, perhaps a little skepticism about the ability of "hot-spotting" to make it all work out is in order, too.
But what I find most striking about Gawande's celebration of the community policing model is how at odds it is with any notion of limited government. He is tone deaf to those who might bristle at the idea of medicalizing society.
This all sounds fine, from a medical perspective. But citizens are not patients.
Brenner is a private citizen doing heroic work. But if this model were to be nationalized, you would in effect have agents of the government serving as lifestyle coaches and health "mothers." Surely you don't have to be a "tea partier" to find that creepy.
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