The Ancient Rome Angle On Mass. Health Reform, Circa 2012

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The emperor Diocletian (
The emperor Diocletian (

Boston Globe columnist Jeff Jacoby is often too caveman-ish for my taste, but he certainly gets erudition points today for comparing Gov. Deval Patrick to the third-century Roman emperor Diocletian.

In a column headlined "On health care, state doesn't know best," he describes Diocletian's "famous" (I guess to everyone but me) "Edict on Prices." It "established price ceilings for a wide range of goods and services," and it totally backfired, leading to hoarding, black-marketeering, speculation and a general economic worsening. Now to the proposals afoot to contain rising health costs in Massachusetts:

These bills aren’t written in Latin and they don’t impose the death penalty, but their core principle is not much different from Diocletian’s: The state knows best. What fraction of the local economy should health care consume? How fast should medical spending rise? On what business model should provider networks be organized? How should hospital and doctors fees be calculated? Where should consumers get information on quality and cost of care? When are a provider’s high rates justified? What penalty should it bear when they aren’t? In the world these plans envision, decision after decision comes not through the voluntary interplay of doctors, patients, hospitals, and insurers, but from government agents who impose them from above.

And his conclusion: "Price controls invariably make economic problems worse. It was true in Diocletian’s Rome. It’s no less true in Deval Patrick’s Massachusetts."

There are already some thoughtful comments, both agreeing and disagreeing, below the column on the Globe's site here. Including:

There is nothing 'voluntary' about health care. Patients are not "consumers." Getting a CT scan when you are in serious pain not the same as buying cat litter. The statement that the a free market consists of "voluntary interplay of doctors, patients, hospitals, and insurers" is absurd. If anything, your argument supports single payer--a well-known and proven solution to the conundrum.

This program aired on May 16, 2012. The audio for this program is not available.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.