Featured Post

Is the new professionalism and ACP's new ethics really just about following guidelines?

The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Sunday, June 05, 2016

Worried about your health care?Do not fear, the Medical Platonic guardians are gearing up

Plato envisioned a utopian society ruled by philosopher kings,leaders with ideas. Brilliant and knowledgeable, logical and devoted to the good of the crowd. Even back then the question was raised, "who will guard the guardians?" or "Quis custodiet ipsos custodes?"

The platonic ideal has persisted through the years since Plato pontificated.Currently those whose world view echos Plato are called progressives or [modern day]liberals as opposed to the classical liberals who hold the opposite view.Also, from what I've read the neo-conservative Leo Straus was a bit enamored with some of Plato views on government.

A apparent modern Plato fan is H.J.Aaron who has had three commentaries in the Perspective sections of the NEJM in the last year. He seems to be their go-to guy for his Platonic mindset and particular for  IPAB issues.Here is a link to  a sample of his views.

He praises Congress for their willingness to "abstain from meddling in matters they are poorly equipped to handle." ( Well, that would be a first) He seems to be aware of Public Choice theory (he has a PhD in Economics from Harvard) when he talks about the temptation of Congress to spend money for political ends but seems to have missed the point when he apparently assumes that the IPAB panelists would be immune to lobbying efforts.Clearly, he believes it is a good and desirable thing for Congress to delegate its powers to agencies and other bodies- a view somewhat in opposition  to what James Madison envisioned but a major feature of the administrative state.

He likens the creation of IPAB to the creation of the Fed Reserve which was to be an entity not subject to congressional control set up a governmental entities largely not controlled by Congress.

IPAB is not much in the news currently as the legislative trigger for its activation has not been pulled  but be aware it is still on the books and is available to be the mechanism by which selfless, wise leaders will direct health care miraculously immune to pressure from  lobbyists representing interests that Madison referred to as factions.

No comments: