This came up in a congressional hearing, with Sam Peltzman, another University of Chicago economist.
Peltzman claimed that there were effective drugs that weren't available because of excessive government regulations.
A congressman asked Peltzman to name one.
Peltzman said he didn't know specific drugs. That wasn't his job. He was an economist, not a pharmacist.
That illustrates one of the differences between economists and scientists. Scientists have an idea that sounds good, so they form a hypothesis, They test the hypothesis in the real world to see if it's true. If it doesn't work in the real world, they ditch it and work on another idea.
Economists come up with ideas that sound good. But instead of testing it in the real world to see if it's true, they just insist that it's true because they're so brilliant and the free market is so wonderful. At least, that's the way University of Chicago economists work.
You know some doctors that are having amazing results, but can't manage to prove it in a double blind study?
Well, considering that all of these physicians I'm speakng of, have been the heads of their departments at hospitals, VAs and teaching hospitals which do a lot of research....and that these cases they're working on, ARE part of studies ongoing...sure, I think they're qualified.
I know some doctors that have been having wonderful, and in some cases amazing results with this type of treatment. And now, sadly, you will have federal bureaucrats and miles of red tape standing in the way.
That is such bullshit. If they were having amazing results, they would be reporting them at scientific conferences and publishing their results, so other doctors could see whether it really was that great, and adopting it if it were any good.
If a doctor could produce results like that, venture capitalists would be throwing millions of dollars at him.
The doctor Gawande interviewed said, “For all the stupid, expensive, predictive-modelling software that the big venders sell, you just ask the doctors, ‘Who are your most difficult patients?,’ and they can identify them.”
The Wall Street Journal required full names on their comments pages.
It didn't work. They had just as many abusive, right-wing idiots as they would get with pseudonyms. I get more rational discussion at Slashdot, so you can imagine.
It's amazing what people will write under their full name. I could have gotten at least one or two people fired by reporting them to their employer, and I could have gotten at least 3 or 4 people visited by the secret service for shooting their mouths off about using their "second amendment rights" against Obama.
I've talked to a lot of lawyers about this. People think they know what the law is, they're sure about it, it looks obvious, they go to court, and lose. That's what will probably happen to Zucker.
I can't write a law review article for you. There are dozens of cases that would be relevant to a situation like this. You can't always find a case that's exactly on point, but the classic product liability cases would form an envelope that the Buckeyball cases, as reported to the CPSC, would fall within.
Magnetic Buckeyballs don't have an useful function, and seem to be inherently unsafe. Every effort over several years by the manufacturer, the CPSC, and public health agencies were unable to prevent children from swallowing them.
In many of the cases reported to the CPSC http://www.saferproducts.gov/Search/Result.aspx?cid=14858&dm=1&pcid=95&srt=0 the parents didn't know anything about the Buckeyballs. Often one child gave the Buckeyballs to another child. Sometimes an infant found the balls despite an effort by the parent to keep them away.
You can never tell how a jury is going to decide, but they're sympathetic to injured children, and they're not sympathetic to a manufacturer who knew that a certain number of people would be harmed. Zucker is a plaintiff lawyer's dream. He insists on continuing to sell them when the CPSC told him to stop, which will destroy him in court. They actually wrote on their web site, "buy a set to stick it to the CPSC."
This is a matter of settled law. Juries and judges don't agree with you.
Craig Zucker is going to get his ass sued, and when the juries see the smart-alec comments he's been posting on his web site, they're going to award enough damages to shut down his business. Which is the way product liability should work.
And we'll see what the CPSC does to him for violating their order.
The CPSC and other regulators did studies of bleach and other toxic household compounds, to find out the most effective ways to stop kids from swallowing them. They worked with the industry, and they studied the way consumers actually use the products to figure out ways of preventing kids from swallowing bleach. They developed new safety caps which made it difficult for kids to open bleach bottles, while not greatly inconveniencing adults who have to use them. They were very successful, and reduced the number of ingestions by half. http://abcnews.go.com/Health/ParentingResourceCenter/household-cleaning-products-pose-poisoning-risk-kids/story?id=11305919#.UBF4U1KVr5w This is basic engineering.
Yes, people who wanted to sell bleach without childproof caps are assholes.
30 years ago, it was very common for toddlers to swallow lye. If they survived, this caused devastating injuries. Can you imagine what it's like for a kid to have his esophagus burned out, and not be able to eat or talk? The CPSC made them put childproof caps on the cans of lye, and they changed the formula. You don't need 100% lye to clear a drain. You have to dilute it anyway. Now it's a relatively rare injury.
What kind of asshole says, "I don't care if 10,000 kids every year swallow lye, and the government can prevent it. It's the parents' responsibility, and even though we can stop it, I don't want to." (Maybe Gordon Crovitz or somebody on the Wall Street Journal editorial page.)
I've talked to government regulators, in the electrical industry, the printing industry, and the chemical processing industry. They're not the arbitrary bureaucrats of Ayn Rand fantasies. They're reasonable people, who have often worked in business themselves and understand the realities of running a business. They try to work with industry and find reasonable compromises that will satisfy everybody. I remember a meeting where some guys from the New York State Department of Environmental Protection were explaining the new toxic waste regulations to a bunch of printers. They said, "We're not going to put you out of business. We don't want to impose unreasonable costs. We'll give you plenty of time and free technical advice. We just can't let you pour chlorinated hydrocarbons into the water supply."
I wonder what you would say if you had a kid who died or had a life-changing injury because you negligently allowed him to be harmed by a consumer product. Because of the government regulators who saved you from your own stupidity, I fortunately won't find out. (Unless you own a gun.)
11yo girl who presented to the emergency department after having swallowed 5... Incident Description: 11yo girl who presented to the emergency department after having swallowed 5 BuckyBalls that she was playing with in her mouth. She obtained these BuckyBalls as a gift from her mother after she saw them in her school classroom, and having several friends who... (More) Product: Building Sets Product Description: 5 small silver balls, approximately 2mm width. Injury Info: Injury, Emergency Department Treatment Received Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
6/22/2012
|
20120523-A51C5-2147467321
9yo boy needed MRI for mental status changes and abdominal scanner went off.... Incident Description: 9yo boy needed MRI for mental status changes and abdominal scanner went off. Went for AXR and metal object appearing to be a bracelet found. Boy subsequently admitted to swallowing magnets 1 mo ago (Bucky balls). After observing for a few days and giving a... (More) Product: Building Sets Product Description: small magnets (buckyball) Injury Info: Injury, Hospital Admission Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
6/6/2012
|
20120507-AC130-2147467809
2 y/o female ingested 2 'buckyball' magnets. Urgent endoscopy performed at... Incident Description: 2 y/o female ingested 2 'buckyball' magnets. Urgent endoscopy performed at night, and magnets were removed endoscopically. She did well afterwards and was discharged home. This was incredibly dangerous given the risk of perforation with such magnets. Product: Building Sets Product Description: buckyball round spherical magnets Injury Info: Injury, Emergency Department Treatment Received Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
5/21/2012
|
20120423-CDEB2-2147468193
14 year old female accidently ingested 5 small rare earth magnets after... Incident Description: 14 year old female accidently ingested 5 small rare earth magnets after attempting to make a tongue ring out of them. She subsequently developed abdominal pain over the coarse of the next 24hrs requiring hospitalization. Medical management was attempted to... (More) Product: Building Sets Product Description: small very powerful magnets about the size of a BB Injury Info: Injury, Hospital Admission Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
5/18/2012
|
20120420-C04A8-2147468264
2 yo boy swallowed "buckyballs" earth magnets, landed in stomach with large... Incident Description: 2 yo boy swallowed "buckyballs" earth magnets, landed in stomach with large portion of stomach mucosa stuck in between magnets. Was successfully removed endoscopically but led to superficial ulce
In May 2010, the company voluntarily recalled 175,000 Buckyball sets at the commission’s request because their labels said products were intended for ages 13 and older. Federal rules prohibit such loose magnets from being sold to kids younger than 14
In the case of the infant who died, it seems that the parents were aware of the danger of small objects and tried to keep the magnetic toy away from the infant. He got it anyway. http://www.washingtonpost.com/wp-dyn/content/article/2006/03/31/AR2006033101897.html It's impossible to keep small magnets away from young children even with the best efforts.
The Buckeyballs are marketed to 14-year-olds. Are you saying that 14-year-olds should be held responsible if younger children ingest them?
The only way to resolve this is in court. We'll see whether the jury thinks Zucker has any responsibility.
Oh, and more importantly, educate doctors, nurses, and poison control centers so that when you ask them if you should worry after a kid swallows one of these things, they immediately tell you to go count them and make damn sure the kid swallowed only one.
You're going to educate doctors about what to do when a kid swallows these things? Doctors know more about this than you do, because they have to deal with the consequences, and that's why they wanted the CPSC to ban them.
The CPSC worked with Craig Zucker for almost a year now, in trying to develop warning labels and warn parents, and it didn't work.
Even if they're used as directed, you're giving them to 14-year-olds. You have to depend on 14-year-olds to be responsible enough not to let younger kids get at them. The results from the emergency rooms is that younger kids are getting them from older kids.
What are you going to do when a 6-year-old swallows one of these -- tell the 14-year-old he got it from that it's his fault because he should have been more responsible?
Hospital emergency rooms send reports to the Consumer Products Safety Commission when someone is injured with a consumer product. When the CPSC sees that a product is injuring or killing a lot of people, they investigate. They tried warning labels, warning videos, and everything else the manufacturer suggested. It didn't work. The kids kept dying. So they finally decided that it wasn't worth it to have kids dying every year just to have a cool toy.
That's the way they are at the CPSC. They don't like to see little kids dying because of frivolous toys.
The problem is that, if you have 2 of them, they don't pass through the intestine like the other stuff kids swallow. They pinch 2 sections of intestine together, crush them, and cause necrosis and blockage, and, like you said, perforation. The kids can die. They need fairly invasive surgery. There weren't too many deaths, but there were a few. The people who brought them to the attention of the CPSC were the emergency room doctors who were dealing with them.
The diabolical thing is that they're so interesting that kids are attracted to them.
Craig Zucker is an asshole. I realize his problem with selling a popular, profitable product, but they've been responsible for a couple of deaths. Too bad. You can't make a million dollars if a 6-year-old kid dies as a result. If somehow he manages to defy or stall the CPSC, he's going to get sued by the next parent whose kid winds up in the ER over them.
I can see Zucker being cross-examined: "You did know that several children had died from swallowing these buckeyballs, didn't you?"
You are correct that the VA system is cheaper than its private competitors and provides better care in many ways, but I'm pretty sure they're not immune to malpractice suits. The health care system for active members of the military and their families does have an unusual situation in which compensation for malpractice is much lower than you could get in a civilian case.
The main advantage to the VA system, I think, is that they have doctors working on salary. When a doctor gets paid $10,000 to perform surgery, he has a strong incentive to do unnecessary surgery. One of the disadvantages is that they have a formulary that supplies just one drug in its class, so if you do better on another drug you may not get the best one.
But getting back to Crovitz' idea that the government can't do anything right, the VA is a clear counter-example.
Slashdot Mirror
This came up in a congressional hearing, with Sam Peltzman, another University of Chicago economist.
Peltzman claimed that there were effective drugs that weren't available because of excessive government regulations.
A congressman asked Peltzman to name one.
Peltzman said he didn't know specific drugs. That wasn't his job. He was an economist, not a pharmacist.
That illustrates one of the differences between economists and scientists. Scientists have an idea that sounds good, so they form a hypothesis, They test the hypothesis in the real world to see if it's true. If it doesn't work in the real world, they ditch it and work on another idea.
Economists come up with ideas that sound good. But instead of testing it in the real world to see if it's true, they just insist that it's true because they're so brilliant and the free market is so wonderful. At least, that's the way University of Chicago economists work.
Place the vessel into a centrifuge but if you don't have that use a good clothes washer on the spin setting.
You can also use a bicycle wheel. Make sure to put one bottle on each side of the wheel for balance.
Well, considering that all of these physicians I'm speakng of, have been the heads of their departments at hospitals, VAs and teaching hospitals which do a lot of research....and that these cases they're working on, ARE part of studies ongoing...sure, I think they're qualified.
Name one.
You know some conmen, not doctors.
But he was wearing a white coat!
I know some doctors that have been having wonderful, and in some cases amazing results with this type of treatment. And now, sadly, you will have federal bureaucrats and miles of red tape standing in the way.
That is such bullshit. If they were having amazing results, they would be reporting them at scientific conferences and publishing their results, so other doctors could see whether it really was that great, and adopting it if it were any good.
If a doctor could produce results like that, venture capitalists would be throwing millions of dollars at him.
They were doing it with computers in New York City since about 1980. It's called Compstat. http://en.wikipedia.org/wiki/Compstat
Before that, they were doing it with maps and pushpins.
There's a similar situation in medicine. Atul Gawande had an article in the New Yorker on using a Compstat-style system for hospitals to find the patients who had the greatest need. http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande
The doctor Gawande interviewed said, “For all the stupid, expensive, predictive-modelling software that the big venders sell, you just ask the doctors, ‘Who are your most difficult patients?,’ and they can identify them.”
The Wall Street Journal required full names on their comments pages.
It didn't work. They had just as many abusive, right-wing idiots as they would get with pseudonyms. I get more rational discussion at Slashdot, so you can imagine.
It's amazing what people will write under their full name. I could have gotten at least one or two people fired by reporting them to their employer, and I could have gotten at least 3 or 4 people visited by the secret service for shooting their mouths off about using their "second amendment rights" against Obama.
No true gun owner would do this. http://en.wikipedia.org/wiki/No_true_scotsman
I've talked to a lot of lawyers about this. People think they know what the law is, they're sure about it, it looks obvious, they go to court, and lose. That's what will probably happen to Zucker.
I can't write a law review article for you. There are dozens of cases that would be relevant to a situation like this. You can't always find a case that's exactly on point, but the classic product liability cases would form an envelope that the Buckeyball cases, as reported to the CPSC, would fall within.
Magnetic Buckeyballs don't have an useful function, and seem to be inherently unsafe. Every effort over several years by the manufacturer, the CPSC, and public health agencies were unable to prevent children from swallowing them.
In many of the cases reported to the CPSC http://www.saferproducts.gov/Search/Result.aspx?cid=14858&dm=1&pcid=95&srt=0 the parents didn't know anything about the Buckeyballs. Often one child gave the Buckeyballs to another child. Sometimes an infant found the balls despite an effort by the parent to keep them away.
You can never tell how a jury is going to decide, but they're sympathetic to injured children, and they're not sympathetic to a manufacturer who knew that a certain number of people would be harmed. Zucker is a plaintiff lawyer's dream. He insists on continuing to sell them when the CPSC told him to stop, which will destroy him in court. They actually wrote on their web site, "buy a set to stick it to the CPSC."
Citation needed.
http://store.westlaw.com/products-liability-design-manufacturing-defects-2011-2012/181671/13975067/productdetail
This is a matter of settled law. Juries and judges don't agree with you.
Craig Zucker is going to get his ass sued, and when the juries see the smart-alec comments he's been posting on his web site, they're going to award enough damages to shut down his business. Which is the way product liability should work.
And we'll see what the CPSC does to him for violating their order.
The CPSC and other regulators did studies of bleach and other toxic household compounds, to find out the most effective ways to stop kids from swallowing them. They worked with the industry, and they studied the way consumers actually use the products to figure out ways of preventing kids from swallowing bleach. They developed new safety caps which made it difficult for kids to open bleach bottles, while not greatly inconveniencing adults who have to use them. They were very successful, and reduced the number of ingestions by half. http://abcnews.go.com/Health/ParentingResourceCenter/household-cleaning-products-pose-poisoning-risk-kids/story?id=11305919#.UBF4U1KVr5w This is basic engineering.
Yes, people who wanted to sell bleach without childproof caps are assholes.
30 years ago, it was very common for toddlers to swallow lye. If they survived, this caused devastating injuries. Can you imagine what it's like for a kid to have his esophagus burned out, and not be able to eat or talk? The CPSC made them put childproof caps on the cans of lye, and they changed the formula. You don't need 100% lye to clear a drain. You have to dilute it anyway. Now it's a relatively rare injury.
What kind of asshole says, "I don't care if 10,000 kids every year swallow lye, and the government can prevent it. It's the parents' responsibility, and even though we can stop it, I don't want to." (Maybe Gordon Crovitz or somebody on the Wall Street Journal editorial page.)
I've talked to government regulators, in the electrical industry, the printing industry, and the chemical processing industry. They're not the arbitrary bureaucrats of Ayn Rand fantasies. They're reasonable people, who have often worked in business themselves and understand the realities of running a business. They try to work with industry and find reasonable compromises that will satisfy everybody. I remember a meeting where some guys from the New York State Department of Environmental Protection were explaining the new toxic waste regulations to a bunch of printers. They said, "We're not going to put you out of business. We don't want to impose unreasonable costs. We'll give you plenty of time and free technical advice. We just can't let you pour chlorinated hydrocarbons into the water supply."
I wonder what you would say if you had a kid who died or had a life-changing injury because you negligently allowed him to be harmed by a consumer product. Because of the government regulators who saved you from your own stupidity, I fortunately won't find out. (Unless you own a gun.)
CPSC accident reports
http://www.saferproducts.gov/Search/Result.aspx?cid=14858&dm=1&srt=0
REPORT
|
7/16/2012
|
20120611-83E1C-2147466743
11yo girl who presented to the emergency department after having swallowed 5 ... ... (More)
Incident Description: 11yo girl who presented to the emergency department after having swallowed 5 BuckyBalls that she was playing with in her mouth. She obtained these BuckyBalls as a gift from her mother after she saw them in her school classroom, and having several friends who
Product: Building Sets
Product Description: 5 small silver balls, approximately 2mm width.
Injury Info: Injury, Emergency Department Treatment Received
Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
6/22/2012
|
20120523-A51C5-2147467321
9yo boy needed MRI for mental status changes and abdominal scanner went off. ... ... (More)
Incident Description: 9yo boy needed MRI for mental status changes and abdominal scanner went off. Went for AXR and metal object appearing to be a bracelet found. Boy subsequently admitted to swallowing magnets 1 mo ago (Bucky balls). After observing for a few days and giving a
Product: Building Sets
Product Description: small magnets (buckyball)
Injury Info: Injury, Hospital Admission
Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
6/6/2012
|
20120507-AC130-2147467809
2 y/o female ingested 2 'buckyball' magnets. Urgent endoscopy performed at ...
Incident Description: 2 y/o female ingested 2 'buckyball' magnets. Urgent endoscopy performed at night, and magnets were removed endoscopically. She did well afterwards and was discharged home. This was incredibly dangerous given the risk of perforation with such magnets.
Product: Building Sets
Product Description: buckyball round spherical magnets
Injury Info: Injury, Emergency Department Treatment Received
Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
5/21/2012
|
20120423-CDEB2-2147468193
14 year old female accidently ingested 5 small rare earth magnets after ... ... (More)
Incident Description: 14 year old female accidently ingested 5 small rare earth magnets after attempting to make a tongue ring out of them. She subsequently developed abdominal pain over the coarse of the next 24hrs requiring hospitalization. Medical management was attempted to
Product: Building Sets
Product Description: small very powerful magnets about the size of a BB
Injury Info: Injury, Hospital Admission
Manufacturer / Importer / Private Labeler: MAXFIELD & OBERTON HOLDINGS LLC
REPORT
|
5/18/2012
|
20120420-C04A8-2147468264
2 yo boy swallowed "buckyballs" earth magnets, landed in stomach with large ...
Incident Description: 2 yo boy swallowed "buckyballs" earth magnets, landed in stomach with large portion of stomach mucosa stuck in between magnets. Was successfully removed endoscopically but led to superficial ulce
The Buckeyballs are marketed to 14-year-olds.
Citations please?
http://www.washingtonpost.com/business/economy/federal-suit-targets-maker-of-buckyballs-magnets-citing-dangers-for-children/2012/07/25/gJQA1lDg9W_print.html
In May 2010, the company voluntarily recalled 175,000 Buckyball sets at the commission’s request because their labels said products were intended for ages 13 and older. Federal rules prohibit such loose magnets from being sold to kids younger than 14
In the case of the infant who died, it seems that the parents were aware of the danger of small objects and tried to keep the magnetic toy away from the infant. He got it anyway.
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/31/AR2006033101897.html It's impossible to keep small magnets away from young children even with the best efforts.
The Buckeyballs are marketed to 14-year-olds. Are you saying that 14-year-olds should be held responsible if younger children ingest them?
The only way to resolve this is in court. We'll see whether the jury thinks Zucker has any responsibility.
In the case of the infant who died, the parents were aware of the danger, they made sure the older children didn't play with the toys when the infant was around, and the infant still found the magnets and swallowed them somehow. http://www.washingtonpost.com/wp-dyn/content/article/2006/03/31/AR2006033101897.html
What are you going to say? "Gotcha! You weren't careful enough!"
Right. There was one death from a similar magnetic toy. http://www.washingtonpost.com/wp-dyn/content/article/2006/03/31/AR2006033101897.html
There have been several cases of children who swallowed them, and needed surgery to remove them.
One death from Magnetix. I probably shouldn't have said that they keep dying. A lot of kids wound up in the ER and had surgery.
http://en.wikipedia.org/wiki/Magnetix#Product_recalls_by_US_Consumer_Product_Safety_Commission
The 21-month-old died even though his parents followed the label and tried to keep the toy out of reach.
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/31/AR2006033101897.html
Oh, and more importantly, educate doctors, nurses, and poison control centers so that when you ask them if you should worry after a kid swallows one of these things, they immediately tell you to go count them and make damn sure the kid swallowed only one.
You're going to educate doctors about what to do when a kid swallows these things? Doctors know more about this than you do, because they have to deal with the consequences, and that's why they wanted the CPSC to ban them.
The CPSC worked with Craig Zucker for almost a year now, in trying to develop warning labels and warn parents, and it didn't work.
Even if they're used as directed, you're giving them to 14-year-olds. You have to depend on 14-year-olds to be responsible enough not to let younger kids get at them. The results from the emergency rooms is that younger kids are getting them from older kids.
What are you going to do when a 6-year-old swallows one of these -- tell the 14-year-old he got it from that it's his fault because he should have been more responsible?
You did realize I was being sarcastic, didn't you?
Hospital emergency rooms send reports to the Consumer Products Safety Commission when someone is injured with a consumer product. When the CPSC sees that a product is injuring or killing a lot of people, they investigate. They tried warning labels, warning videos, and everything else the manufacturer suggested. It didn't work. The kids kept dying. So they finally decided that it wasn't worth it to have kids dying every year just to have a cool toy.
That's the way they are at the CPSC. They don't like to see little kids dying because of frivolous toys.
Right, if a 14-year-old isn't responsible enough to keep them out of the hands of his 10-year-old brother, the kid deserves to die.
I've seen the x-rays.
The problem is that, if you have 2 of them, they don't pass through the intestine like the other stuff kids swallow. They pinch 2 sections of intestine together, crush them, and cause necrosis and blockage, and, like you said, perforation. The kids can die. They need fairly invasive surgery. There weren't too many deaths, but there were a few. The people who brought them to the attention of the CPSC were the emergency room doctors who were dealing with them.
The diabolical thing is that they're so interesting that kids are attracted to them.
Craig Zucker is an asshole. I realize his problem with selling a popular, profitable product, but they've been responsible for a couple of deaths. Too bad. You can't make a million dollars if a 6-year-old kid dies as a result. If somehow he manages to defy or stall the CPSC, he's going to get sued by the next parent whose kid winds up in the ER over them.
I can see Zucker being cross-examined: "You did know that several children had died from swallowing these buckeyballs, didn't you?"
You are correct that the VA system is cheaper than its private competitors and provides better care in many ways, but I'm pretty sure they're not immune to malpractice suits. The health care system for active members of the military and their families does have an unusual situation in which compensation for malpractice is much lower than you could get in a civilian case.
The main advantage to the VA system, I think, is that they have doctors working on salary. When a doctor gets paid $10,000 to perform surgery, he has a strong incentive to do unnecessary surgery. One of the disadvantages is that they have a formulary that supplies just one drug in its class, so if you do better on another drug you may not get the best one.
But getting back to Crovitz' idea that the government can't do anything right, the VA is a clear counter-example.