Ron Wyden was in fine form today in the Times, displaying his ignorance moderate credentials for all to see. Consider this sentence:

To stay competitive, insurers would need to follow the example of places like the Mayo Clinic and offer good, low-cost coverage.

Now Wonks Anonymous realizes that the Mayo Clinic is all the rage these days and every politician wants to get on that bandwagon. He was not aware, however that the Mayo Clinic even offered health insurance.

Maybe he was really thinking of Kaiser Permanente which does produce health care and, at the same time, offers prepaid medical plans - health insurance.

Whatever Senator Wyden was thinking, he is sadly mistaken if he thinks that the allmacht of competitive pressures will transform health insurers into some new kind of health care providers.

Health insurers are staffed by MBAs, accountants and actuaries. They sell contracts which promise to pay for health care and then try to pay for as little health care as possible while still coming within the letter of the contracts.

All of the Accountable Care Organizations, including the Permanente Medical Group, are run by doctors, for doctors, using doctors unique knowledge and skills.

Health insurers know nothing about medical science or individual patients or any other aspect of medical care. They can buy superficial knowledge of some of these things through consultants but anyone who has worked with consultants knows how well that works.

To expect competitive pressures to transform Health Net into another Kaiser Permanente is the crudest economic Lysenkoism. It is pushing pigs off the barn and expecting them to grow wings.