26 August 2015

Ben Carson Would Like to Put an End to Career Politicians. I Would Like to Put an End to Career Surgeons

Health care costs are ridiculous, devouring 17% of GDP. And an often overlooked fact is that more experienced surgeons make more than inexperienced surgeons. My own guess is that if we set up term limits for surgeons - limiting their careers to, say, 5 or maybe 10 years, we could lower health care costs by tens of percent. Worse yet, experienced surgeons get cozy with pharmaceutical companies and medical device manufacturers, often wantonly spending patients' money on products of dubious value but outrageous cost. Plus everybody knows that no one is as arrogant as an experienced surgeon.

Some of my more radical colleagues in this "term limits for surgeons" movement don't even think that surgeons should be required to study medicine. The study of medicine makes them biased towards, well, traditional medical thinking, and tends to close their minds to options like herbal remedies or faith healing. Plus it raises the costs for entering the career, putting pressure on surgeons to stay in the career longer. The problem is, of course, patients grow alarmed when surgeons unclear about where to cut or what to do come into the consulting room smiling and shaking hands. That could easily be overcome by earlier administration of anesthetic.

Ben Carson has a similar initiative for putting an end to career politicians. His argument is fairly simple.

Government costs are ridiculous, devouring 18% of GDP just for the federal government. Career politicians become too insular, too cozy with lobbyists. They tend to spend voters' money on policy initiatives of dubious value and outrageous cost. And politicians who stay in the field longer raise more money than novice politicians. And no one is more arrogant than a career politician. Carson's own guess is that if he were to limit political careers to, say, 5 to 10 years, he could lower government costs by tens of percent.

I don't know about this. I'm not sure that I want a novice stumbling into negotiations with Iran or Wall Street lawyers, or like the idea of forcing someone out of office just as they gain some experience and knowledge of the job. It seems to me that this would give lobbyists a huge advantage in negotiating any deals between industry and taxpayers; taxpayers would be represented by people who are not only paid much less than the lobbyists they face (that is, of course, already the case) but people who would have far more experience.

Carson's idea for term limits for politicians shows incredible naivete about the complexity of modern policy, the need to balance economies and ecosystems, safety and freedom, progress and fairness, and private and public initiative. He's a surgeon more than willing to walk into the Oval Office to make policy, even though he's had no political experience. That's silly. It would actually make more sense for a career politician to walk into a operating room to perform surgery; at least that only involves the fate of one person - not millions - and there is a clear consensus about best practice for surgeries.

So ignore Ben Carson. He's just a surgeon. I do hope you listen to me, though, and join me in this move to establish term limits for surgeons. It's way past time to bring down health care costs and we should start with the highest paid in the field.

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