Donald Trump’s Department of Government Efficiency plan is to cancel major regulations, reduce headcounts, and defund inadequately-authorized expenditures and waste, but not to shrink entitlement programs.
This plan would require legislators to stop using the executive power to allocate budgets, presidents and bureaucrats to stop using legislative power to pass rules, and judges to start opining quickly and broadly against presidents and bureaucrats.
Congressmen, presidents and bureaucrats, and judges have other plans.
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Trump’s delegees Elon Musk and Vivek Ramaswamy are entrepreneurs who have managed people. Musk has made processes and products work far better. Both will appreciate the value of creating a big win for politicians.
Politicians’ job here is simple. Politicians just need to support customers’ freedom.
Freedom
In innovative sectors, for example in computers, people work together collaboratively. Producers compete to produce more-desired products. Customers each choose what’s best for them. Customers’ choices determine which producers succeed and which producers fail.
In healthcare, though, government people have long taken control away from the customers and taken control themselves to benefit themselves and their cronies.
This system’s value-adding producers—the clinicians, testing producers, therapy producers, and facility owners and operators—are isolated from customers by a massive government/cronies bureaucracy. At this point even these value-adding producers are to a large extent cronies too.
The government people do favors for their cronies, and their cronies kick back contributions and favors.
That’s fascism. It’s tyranny. It also makes governments’ and individuals’ current healthcare spending wasteful, and makes their future spending keep getting ever-more wasteful.
The Constitution gives each government official the power, and the duty, to not enforce and not respect the unconstitutional statutes and regulations that hold this system in place.
Consider what might happen if officials in a state government or in the national government would immediately stop enforcing or immediately repeal all healthcare-related rules and regulations.
This would be freedom. Might this also be anarchy? No, not really. But even so, the system wouldn’t right itself quickly.
At first, out of necessity, the current producers would keep following all of the newly-obsoleted rules.
In time, the system’s incumbent political entrepreneurs would face competition from business entrepreneurs. These business entrepreneurs would need to settle on what products they would offer, at what prices, communicated in what ways, and marketed and sold in what ways.
In short, the key would be to develop customer-facing pricing. This sounds simple enough. Except:
- The current government/cronies system has limited the producers’ abilities to communicate prices and quality to customers. Customer-facing pricing for the myriad, complex healthcare products would take time to develop.
- Also, the current system has limited the supply of producers. Producers are highly skilled, and production facilities are highly specialized. Increases in supply, where needed, couldn’t be brought online until after substantial delays.
Given these hurdles, at first the increase in freedom would feel like a crisis.
This would work in the favor of the government/crony incumbents. Most would push hard to reimpose the unconstitutional rules.
Congressmen, presidents and bureaucrats, judges, and cronies would try to keep working their timeworn plans.
Product Regularization
But another path could be taken, either while simultaneously increasing freedom, or before increasing freedom: legislators could develop minimum rules to make healthcare products regularized.
Congressmen have power to develop minimum product-regularization rules, even within states. The Constitution’s guarantee of a republican form of government requires popular rule, which residents are deprived of when government people don’t represent the residents’ interests but instead represent cronies’ interests.
State legislators also have power to develop minimum product-regularization rules.
In either case, legislative power can’t constitutionally be delegated. So, the rules would need to be sufficiently simple and clear that legislators who lack healthcare expertise could themselves write and pass the rules.
Also, the rules would need to make healthcare product descriptions sufficiently simple and clear that customers could use these descriptions to make their best choices when they shop:
- A fee for office work could be like a lawyer’s rate for office work. A fee for surgery could be like a lawyer’s rate for courtroom work.
- Test instructions could be transmissible to testing producers. Also, testing producers could list their pricing.
- Therapy recommendations could be readable by customers. The recommendation on a drug, for instance, could provide all the information that would be needed to shop for the drug if it was available over-the-counter.
- Procedures could have full packages of features built in, like auto models have. Foreseeable complications could be priced separately, and a worst-case total not exceeded.
Quality could be quantified. Procedure sellers could use their past rates of complications to calculate their customers’ average cost for complications.
Customers could then compare procedure sellers’ total price plus complications, like customers compare product sellers’ total price plus shipping.
Legislators could simply require producers to satisfy such usability requirements and list their pricing and accurate complication costs, or face stiff fines and lawsuits. Customers and producers would take it from there.
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Pricing is a bedrock way that knowledge gets used in society. Knowledge is power.
Politicians, colluding with producers, have created and kept in place impenetrable, harmful pricing.
But this problem is a golden opportunity for politicians to quickly restore freedom that will save lives. Savvy politicians can make themselves heroes here.
Each time a sector becomes more free, it become more and more efficient. Everybody’s money buys more of what they want. Here, government healthcare spending would go farther, and government retirement spending would go farther. Individuals’ spending would go farther too.
Trump’s efficiency department could tout win after win without making lasting improvements. Or, Trump’s efficiency department could free producers and customers to work together well, like they do elsewhere, in the life-or-death sector that’s the key to spending, now and in the future: healthcare.
Bring healthcare freedom for the win.
