Scraping Away the Bureaucratic Barnacles

James Howard Kunstler sounds positively 'Paulian' in his conclusions about the recent health care summit:

I am personally not confident that we will do anything to address the failures and inequities of so-called Health Care. As a general thing, I have to say that this recent exercise only seems to prove the now permanent impotence and impairment of the federal government. In The Long Emergency we have entered, real governance is likely to devolve downward to the community level, and it may be unrealistic to expect any real action from on high. Things have just gone too far at this point. We have blown past the thresholds of hyper-complexity so that further hyper-complexity only make things worse. At more than 2,000 pages, the current Health Care Reform bill is surely an exercise in the diminishing returns of grotesque additional hyper-complexity.

I am confident in the "emergent," self-organizing capablities of human societies. We are now faced with the task of emergently re-organizing medicine downward to the community clinic level -- and sooner or later probably toward a simple, straightforward pay-as-you-go in cash basis with doctors you know, with all the bureaucratic barnacles scraped away. Like a lot of other things in the years ahead -- education, retail trade, transport, even banking -- medicine is likely to be much less dazzling than the way it is practiced today. But when all is said and done we'll still possess the germ theory of illness and the recipe for lidocaine and a few other things that will make existence tolerable.

But if I don't also share the following paragraph, you wouldn't really get the flavor of Kunstler's column today:

All I can offer, really, are observations: for example, that Congressman John Boehner (R -Ohio) needs a set of steel ball bearings to roll around in his hand to perfect his otherwise dead-on impersonation of Captain Queeg, the paranoid villain of that 1950s movie The Caine Mutiny.  I kept wishing that President Obama would reach under the table for a fungo bat every time the miserable Mr. Boehner opened his Midwestern pie-hole to drone out a new lie, and split his f******* head open like a Crenshaw melon -- but perhaps my fantasies are excessively baroque.