Where wisdom died...a response to David Brooks

NYT David Brooks' piece on Medicare -- he's trying to provide defense of Paul Ryan's plan (that would lead to 2/3rds of Medicare costs to be paid by seniors) by insisting that seniors would help save money if they got to choose which services they need -- gets debunked by economists on the topic of savings, here.


I'm however taking issue with some concepts that are illustrated by this excerpt:

"Republicans (at least the most honest among them) believe that the world is too complicated, knowledge is too imperfect. They have much greater faith in the decentralized discovery process of the market.  ...  In the age of the Internet and open-source technology, the Democrats are mad to define themselves as the party of top-down centralized planning."

So, if the world is "too complicated" and knowledge "too imperfect", why is it that Brooks believes that individuals should be able to make wise choices for themselves?

So what if millions of people have access to the internet.  First, not everyone knows how to use the internet; second, not everyone can properly interpret information culled from the internet (think lemon juice bandit); third, why do people constantly ask me for the answers, when the answers they seek are just an internet query away?

Is Brooks really suggesting that centralized planning, conducted with people holding advanced degrees and high knowledge of their specific areas, is not any better at making choices (and interpreting the data) for Americans who otherwise have no college degree, let alone a high school degree?  Let me simplify it: do you hire someone with knowledge in CAD, to do CAD drafting, or do you hire any schmuck off the street?

If anything, it's the other way around: seniors will simplify their choices (and limit their time spent on researching) by always choosing the least expensive options.  Sounds exactly like the Republican intention, right?  But to stay under the Medicare voucher value, seniors will end up forgoing some coverage items, and will end up paying from their own pockets for items that were unexpected, or dismiss treatment altogether.  You either end up with seniors going broke (don't we already have this issue?) or dying early out of rationing of care.

Though he says that this gives individuals the right to choose their health care, it's clear Brooks is suggesting that individuals are better at making economic decisions for themselves...but health care shouldn't be considered an economic decision, should it?  Respectively, should it be a senior's economic decision to skip out on hospital care, for hospice care?  Should it be an economic decision between new, advanced drugs, and older ones that are generic, and are less effective?  Should it be an economic decision between preventative care and emergency care?

It is a recipe for disaster, to turn health care decisions for the elderly into an economic decision.  Remember the law of unintended consequences?  Here's one: a big rise in senior citizen suicides.  Here's another: higher premiums for non-seniors.