> Medicare is referring to the newly created Center for Medicare and Medicaid Innovation, which gives the program power to create and expand projects without co

> Medicare is referring to the newly created Center for Medicare and Medicaid Innovation, which gives the program power to create and expand projects without congressional authorization. This authority could also be used to create projects based on HQP’s lessons. It’s not. Instead, Medicare has created a raft of projects and experiments meant to move the system from fee-for-service toward pay-for-quality — with the hope that if they can get the payment incentives right, then the market will have reason to support programs like HQP. Yep. As long as the government bureaucrats develop perfect payment incentives, the market will do its job. It's the same story in education. And programming - if you can find the perfect metric for code production (SLOC? function points? story points?) you don't need to do anything else. But with an imperfect metric, Cambell's Law (http://en.wikipedia.org/wiki/Campbell%27s_law http://en.wikipedia.org/wiki/Campbell%27s_law) kicks in. Want to reduce waiting times? Kick out patients so they die at home. Increase successful surgeries? Tell the doctors to fix a lot of ingrown toenails. Increased lifespan? Make decisions which increase life expectancy, at the expense of quality of life. Or just try to get rid of patients who have poor prospects. The greatest strength of markets is also their greatest weakness - they are much smarter and more agile than government departments. They can become a malicious literal genie, which optimises whatever the incentives are.