Lane on Cost-Control


Like many people, for years I’ve known Charles Lane only from the “Charles Lane” character in Shattered Glass. Thanks to the emergence of the Post Partisan blog, however, we get to see his writing and he turns out to be . . . incredibly annoying. For example, one aim of health reform is to control costs by curbing useless or counterproductive medical procedures. He counters this with the observation that when useful new treatments are developed then people want them.

True enough but . . . so what? Obviously, if you just wanted to control costs in a totally arbitrary way this would be both easy enough as a conceptual matter and also a bad idea. The goal of health reform legislation, however, is to control costs by reducing waste and counterproductive treatment. If Lane has some insights to share on this subject, he might mention them.

Otherwise, I’ll just observe that there’s a certain kind of individual—heavily represented in the Washington Post opinion pages—whose interest in public policy seems largely motivated by a kind of rancid misanthropy. This leads to classic pain caucus thinking whereby the sole demonstration of one’s “seriousness” is a politicians is one’s willingness to afflict clear and demonstrable harm on one’s constituents. But while public policy certainly does involve tradeoffs, it’s simply not the case that policy debates typically concern strictly zero-sum matters. One way to control health costs, for example, is to change payment structures to give hospitals and hospital personnel more incentive to avoid medical errors. Giving doctors statistically valid advice about the relative efficacy of different treatment modalities, rather than relying on anecdotes and guesswork, also holds promise. So does funding efforts to build healthier communities. All this stuff is in the bill. Lane could write about it! But no.