Deeper Dissection #8:

Marx & Central Planning

That’s the impossible question Medicare decided it could answer. Instead of letting markets decide, they turned to a prospective payment system and central planning. The result was the Resource-Based Relative Value Scale (RBRVS), an attempt to measure “value” in medicine not by what patients want, but by how much work a doctor puts in.

It’s the same flawed thesis Karl Marx once promoted: that value comes from labor. And just like every other experiment in central planning, it created distortions, inefficiencies, and politics. It’s the direct offshoot of making every doctor a government contractor, the original sin that still haunts American healthcare today.