Market Driven Health Care

After passage of the soon-to-be disastrous Medicare bill, aWol is crowing about the Repug stranglehold on the law making apparatus. And, as always, the Wall Street Journal joins in.

One of today's opinion pieces makes the hard sell - again - for a health care system driven by... what else... the free market. The author, Regina Herzlinger, is not a doctor, not a health care professional of any kind. She's not even an HMO or insurance company flack. Ms. Herzlinger is a professor of business administration at Harvard. Surprised? No? Me neither.

I won't go into a lot of detail about the article - it is the usual pean to free markets. What I will do is say one thing about what I believe a true, free market for medical care will get us all.

Porsche vs Yugo.

I don't believe that access to medical care is a fungible, consumer good; it is not just another discretionary purchase. For those who need medical care, that service is not readily exchangeable for another set of goods or services: if a heart transplant patient can't afford the suite of devices and services that treatment requires, he cannot either shop for something a little cheaper or decide to put it off and buy that new pair of sneakers he's been eyeing instead.

And yet a market driven health care system would treat people like customers instead of like patients. The "system" would offer all the best treatments with all the latest drugs and devices and would price them according to demand (and the cost of provision). Just like cars. You want that heart transplant which requires the latest techniques and devices? You can have it - as long as you can afford it. Yes, sir, here's your Porsche! Otherwise, save your pennies or you can mosey on down to the Yugo dealer down the street. They'll give you some aspirin, maybe. Or some generic drug that's three generations removed from the current one.

Is that how we want to treat our fellow citizens who need help? Is that how we want to be treated when we are in need? According to the Rethuglicans, yes.

Turns out accessible health care falls into the same category as international treaties like the Montreal Protocol (see the post below). It helps out mostly poor people. And we know what kind of deal BushCo likes to give them.