Retard Innovation

David Brooks, in the New York Times, supports the Wyden approach to health care reform, which he says infuses a combination of universal coverage and (consumer) choice. Brooks favors a more transparent system, in which people see the consequences of their choices.

Brooks points out the many weaknesses of The Baucus approach. "It entrenches a flawed system. It creates greater uniformity and rigidity ... It squeezes people into a Rube Goldberg complex of bureaucracies ...

The biggest problem is that it will retard innovation. Top-down systems just don’t innovate well, no matter how many Innovation Centers you put in ... The bill will retard innovation"

The problem with individual consumer choice is that, while desirable (and transparent), it alone is insufficient to overcome such powerful forces such as insurers, employers, pharm, government, and even the complexities of illness itself. Neither the pending bills, nor Brooks himself, defines an important role for the physician. Physician driven innovation will be needed to define and to sustain true reform.