For a while there I tried to listen to President Obama's "summit" with the Republicans on health care. But when Senator Schumer started praising Republican Senator Coburn's suggestion of the government sending "undercover patients" in to doctors' offices -- "a great idea," Mr. Schumer said -- I turned it off. It brought to mind civil liberties lawyer Harvey Silverglate's answer to my question about the difference between entrapment and an actual crime. It's a classic approach with Mr. Schumer to suggest a new government program to undo the effects of another government program. When people spend their own money, they watch it carefully to make sure it isn't wasted. When they are spending, in Medicare or Medicaid, the government's money, they don't care as much whether a doctor overbills, because they aren't paying. Instead of sending in a team of government agents in as pretend "patients" to waste time that doctors could be using to treat genuinely sick patients, why not deal with the original distorted incentive by eliminating the third-party payment? When the Republicans and Democrats start agreeing on bright health care ideas, it's a good signal for patients and taxpayers to get nervous. Can you imagine the scandal when a genuinely sick person dies in the waiting room because a doctor or a nurse was busy dealing with an undercover fraud investigator disguised as a "patient"? Senator Coburn is a physician himself and has a reputation as a conservative. Maybe I am overreacting or paranoid, and the idea isn't that dissimilar to undercover drug busts or to sending "testers" out to interview for jobs or try to rent apartments as part of enforcing civil rights laws. But I can't escape seeing similarities to the Soviet Union's spying on its own citizens. In order to obtain an appointment with a doctor, the undercover patient will probably have to lie about why he or she really wants to see the doctor. And once a government starts telling lies to its own citizens as a matter of official policy -- well, it's hard to see it as conducive to freedom.
Obama's Health Care Summit and Undercover Patients