This little ditty comes to mind when I think about deregulating health care. Back when I was a Moscow correspondent, I heard Russians repeat this phrase when they were looking for a decent doctor. With few exceptions, the leftover Soviet health care system was simply awful, thanks in part to a level of regulatory ineptitude that Americans probably can’t imagine. Nursing care was primitive. If you were lucky, your surgeon was sober. If you weren’t really sick when you went into a hospital, you certainly were after you got there.

So ordinary Russians often sought a doctor who was moonlighting illegally and the ditty was code meaning he was competent. If his clandestine office had shiny wood floors, the logic went, the patient volume proved that he or she was good. I pondered this as I edited a story in this issue (Page 45) on Virginia’s upcoming efforts to deregulate health care.

True, Virginia and the United States have some of the highest levels of care, especially at more advanced levels. But since many regulations were drawn up 20 or more years ago, the rules often don’t account for technical advances that can make care cheaper, more productive and more convenient. The medical establishment is loath to embrace many such advances because it threatens the way they fund medicine done the old way, with many technicians, nurses and doctors.

While deregulation can help bring technology to market faster, doing so too quickly can also mean a major decline in quality. Deregulation sure didn’t improve airline service. In health care, the stakes are much higher. Moving too fast would propagate a slew of small, unsupervised clinics that would go into business overnight. More than a few would be run by doctors whose floors are more pigsty than parquet. That, in turn, would touch off a stampede of mergers, hurting the poor, the rural and the uninsured. I’ve already seen a health care catastrophe in a foreign country. I’d sure hate to see one at home.