Michael Hebert on the annual dance we do with Congress on the Medicare fee cuts:

There are ways to encourage doctors to be more cost efficient. Giving them a salary cut every time medical costs rise faster than the price of rice is not one of them.

And anyway, it hasn’t worked. Medical costs continue to outstrip GDP growth regardless of the threat of cuts. This is not a surprise. What doctor is going to choose to use a cheaper antibiotic to treat a patient with pneumonia because it will affect the Medicare reimbursement formula? There are too many billions being thrown around in Washington for any one doctor to think saving a few hundred here or there will change the big numbers. As the Chinese say, in an avalanche, no snowflake feels responsible. Or as I say, you can’t convince somebody to eat fewer beans by arguing that flatus contributes to global warming.