More equal than others

Wobegon math in Washington state

A friend up in Washington state—I'll call him “GW”—writes with exciting news he received from one of his U.S. senators. Patty Murray is irked that her state's citizens are being shortchanged in Medicare reimbursements from the federal government. She says Washington state is being punished for its highly efficient Medicare program. Murray may have a point: It's much too easy to fund certain programs based on percentages of prior expenditures, meaning that every dollar wasted today becomes an extra bit of funding tomorrow.

The senator's remedy, however, comes straight out of the Lake Wobegon playbook (where “all of the children are above average”):

Last week, I joined with Congressman Adam Smith (WA-9) to introduce the Medifair Act, a bill that aims to fix national Medicare reimbursement disparities that hurt Washington state. The bill raises Washington state's Medicare reimbursement rates to the national average and ensures that all states receive at least the national average of per-patient spending. This will encourage doctors to provide Medicare in more areas and will improve access for our state's seniors.
GW is, of course, delighted by Sen. Murray's determination to help him and other Washingtonians obtain better health care, but he admits to being puzzled by her larger objective:
[S]he says that the act “ensures that all states receive at least the national average of per-patient spending.”

How can that be? You can't have some states or some doctors getting more than the average, while everyone else gets the average! Is that just typical wishful thinking (i.e. pandering) on the part of a politician?
Hmm. Is it wishful thinking? Is it pandering?

Can't it be both?


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