Healthcare Engineering

A recent editorial published by the Wall Street Journalelegant, not heinously complex. Trial-and-error is for
describes Congressional Democrats as waging a quietthe laboratory, not for determining the fates of
war against medical specialists in order to pushhuman beings.
through health reform. "With almost no scrutiny," sayDemocrats are not the only social engineers in
the authors, "[Democrats] are trying to engineer aWashington. Republicans are calling just as loudly for
cheaper system so that government can afford toincentives for states and small businesses; incentives
buy health care for all-even if the price is fewer andfor prevention and wellness; reforms to end
less innovative ways of extending and improvingdiscrimination on the basis of preexisting conditions. In
lives."1her book The Forgotten Man, Amity Shlaes discusses
Pseudo-scientific "engineering" has become a favoritehow Republican President Herbert Hoover was one
technique of today's legislators. Lawmakers believeof the earliest and biggest social engineers of all.
they can improve healthcare by fiddling withArmed with the false vision that finely-tuned
reimbursement percentages, tinkering with formulas,government programs could cure society's ills
and coming up with incentives for activities (and(because he had once been a successful engineer),
constituents) they favor and penalties for those theyhe continued to make mistake after mistake until the
do not. Either our representatives do not recognizecountry slid into the Great Depression.2
that each of their solutions creates a new problem,If Democrats and Republicans want to fix healthcare,
or they know that the effect will be sufficientlythey should start by repealing the convoluted
hidden under the complexity of the system.programs, penalties, and regulations that hamper the
Social engineering is the manipulation of people, notfree market. Take the monkey wrenches out of the
the protection of rights. It also happens to be anmachine. Disassemble the monstrous contraption that
insult to real engineering. Real engineering implies theyou have constructed.
use of long-term thinking, not short-range guessing. It1 "The War on Specialists" Wall Street Journal,
implies a respect for cause and effect, not blind hope.October 6 2009
Real engineering yields solutions that are simple and2 Shlaes, A. The Forgotten Man HarperCollins.