TightWind is written by Kyle Baxter. Stay Hungry. Stay Foolish.

Here is Donald Berwick’s ode to the NHS. Some have suggested that quotes used from it have been used unfairly. It’s rather clear they haven’t.

Berwick believes that politics provides for more accountability than markets, and is more just and honorable. Here’s how he describes how the NHS provides accountability:

Ultimately, the buck stops in the voting booth. You place the politicians between the public served and the people serving them. That is why Tony Blair commissioned new investment and modernization in the NHS when he took office, it is why government has repeatedly modified policies in a search for traction, and it is why your new government chartered the report by Lord Darzi. Government action on the NHS is not mere restlessness or recreation; it is accountability at work through the maddening, majestic machinery of politics.

And how he characterizes the market:

You could have obscured – obliterated – accountability, or left it to the invisible hand of the market, instead of holding your politicians ultimately accountable for getting the NHS sorted. You could have let an unaccountable system play out in the darkness of private enterprise instead of accepting that a politically accountable system must act in the harsh and, admittedly, sometimes unfair, daylight of the press, public debate, and political campaigning.

And:

In the United States, our care is in fragments. Providers of care, whether for-profit or not-for-profit, are entrepreneurs. Each seeks to increase his share of the pie, at the expense of others.

And:

I find little evidence anywhere that market forces, bluntly used, that is, consumer choice among an array of products with competitors’ fighting it out, leads to the health care system you want and need. In the US, competition has become toxic; it is a major reason for our duplicative, supply-driven, fragmented care system. Trust transparency; trust the wisdom of the informed public; but, do not trust market forces to give you the system you need. I favor total transparency, strong managerial skills, and accountability for improvement. I favor expanding choices. But, I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.

So: the political system is “transparent,” “majestic,” accountable, and somehow wonderfully competent, while the market is darkness and entrepreneurs are blood-suckers looking to exploit everyone else in a zero-sum game.

This is the man Obama appointed to run Medicare and Medicaid without so much as a single Senate hearing. Ironically, a man who praises the government’s transparency was appointed to office without a single opportunity for the public, and its representatives, to inspect his credentials and philosophy. Twisting the irony dial even closer to eleven—the man who appointed him, Barack Obama, won his election promising a new era of transparency.

I don’t think that’s irony. I don’t for a second believe that Berwick or Obama have any interest in transparency, except when it’s convenient for them. They are interested in controlling society, shaping it in their mold, and forcing every individual to bend to their will, because they believe not only that they know better than everyone else, but that they have the right to force their views onto us.

His nomination is no accident. This is what this administration believes in and ultimately wants to bring to America. And when a little Senate hearing, a little public scrutiny, stands in the way of their agenda, they’ll sidestep it. The ends justify the means.