Unintended consequences – Freakonomics

I loved reading the book Freakonomics. I also often read the blog and the NY Times columns. Today’s column explains a very important concept – the law of unintended consequences.Unintended Consequences

So does this mean that every law designed to help endangered animals, poor people and the disabled is bound to fail? Of course not. But with a government that is regularly begged for relief — these days, from mortgage woes, health-care costs and tax burdens — and with every presidential hopeful making daily promises to address these woes, it might be worth encouraging the winning candidate to think twice (or even 8 or 10 times) before rushing off to do good. Because if there is any law more powerful than the ones constructed in a place like Washington, it is the law of unintended consequences.

I am always wary of proposed laws that seem to do good. Would universal health care laws improve health care? Perhaps, but many would argue that the unintended consequences of the proposals would actually worsen health care.

One of the goals of RBRVS was to improve reimbursement for primary care (if I recall correctly.) Yet the implementation of RBRVS has increased the pay disparity amongst physicians. I strongly believe that RBRVS has increased health care costs, even though it was a proposal to decrease health care costs.

Always remember the famous HL Mencken quote – “There is always a well-known solution to every human problem–neat, plausible, and wrong.” The law of unintended consequences has a major impact on the truth of his statement.