Thursday, March 29, 2018

Thinking About the Health Care System, Part 2

Last week, I posted the first of a series of articles on the topic of our health care system in America. My intent is to focus first on how it became the contorted mess it is today, and finish with my proposal for how to fix it.

In the first article, I proposed that one contributing factor to the situation was the traditional American focus on self-reliance and individual responsibility. Today, I'll float what I believe is the second major reason for our health care mess:

Americans believe that the free market will always deliver a better, cheaper product or service than any government-run alternative.

Well, maybe.

There's certainly no argument that a capitalist, profit-driven free market system has worked well for the United States. We have, on average, a high level of prosperity and quality of life, and access to a range of goods and services most other nations might envy. But is a profit-driven free-market system the best approach to the delivery of medical care if the people who need it can't afford it?

Those who advocate the free-market approach to health care claim that providers who charge too much ("more than the market will bear") will be driven out of business by their cheaper competitors. This sounds pretty good in theory, but if it were true, we wouldn't have the problem of unaffordable health care we have now, would we?

Consider that it's economically advantageous for a profit-driven system to keep the prices for services as high as the market will bear*. Consider also that manufacturers of drugs do not have an economic interest in developing medications to address rare illnesses and conditions. These do not speak highly of the capitalist free market as a particularly good approach to moderating the cost of health care.

Most developed countries have a government run national health insurance program, sometimes with optional insurance plans available for those who can afford them. In general, these programs work well, although - as with any system - there are apocryphal horror stories. Americans, though, are conditioned to assume the superiority of the free market and to believe the relentless drumbeat from the right that anything run by the Big Bad Government™ is by definition doomed to failure because of gross government ineptitude.

So, my proposed second major reason for the health care mess is a belief embedded in the American DNA that only a capitalist, free-market approach to health care is acceptable.

We'll look at my proposed third reason in the next installment of this series, coming in a few days.

Have a good day, if you can afford it. More thoughts tomorrow.


* I'm reminded of the famous comment by French economist Jean-Baptiste Colbert about taxation, that "The art of taxation consists in so plucking the goose as to procure the largest quantity of feathers with the least possible amount of hissing." In the case of health care, we all know who's getting plucked.


Mike said...

An unregulated free market will create monopolies faster than you blink.

allenwoodhaven said...