Tuesday, October 9, 2012

Capitalism and healthcare--a match NOT made in Heaven

Recently, there's been a lot of talk about how each candidate will handle healthcare.  Mitt Romney's plan is to let the market dictate healthcare costs.  This is not a good idea.
1. Unlike cars, timeshares, or even the Adam Smith standby of eggs, people do not buy increasing amounts of healthcare simply because there's a drop in price.  When was the last time a hospital offered a sale on casts and splints?  Or penicillin?  No facility would do it because IT DOESN'T WORK!  No one will line up to take advantage of such a discount.  People only buy healthcare as needed.  The only time affordability becomes an issue is when consumers delay or avoid buying necessary treatments because they can't afford it.  These non-consumers then face either a reduced quality of life, or they die.
2. Unlike food, clothing or housing, substituting cheaper forms of healthcare doesn't always work.  Can't afford a house?  Rent a smaller apartment.  It serves the same purpose.  Same thing with groceries.  If chicken is on sale this week, you'll buy it instead of beef.  Or, you'll buy eggs or beans.  However, there are few alternatives to open-heart surgery.  Even certain medications must be given in their brand-name form, as patients can be sensitive or allergic to an additive in the generic.
3. Market forces dictate that companies produce that which is the most profitable, not always the most necessary.  This explains why there are constantly new medications for acid-reflux disease, while cancer (less common but far more deadly) is still being treated with the same radiation and chemotherapy which have been used for decades despite their horrific and well-documented side effects.
4. Any market that exists outside of an economics textbook has a fair amount of collusion.  This can take many forms when it comes to healthcare, such as all health insurance companies fixing premiums while denying care for pre-existing conditions, to pharmaceutical companies paying their competitors to keep generic versions of newly off-patent medications off the market.  It's reprehensible, but it's all legal.
For a long time, we've let the market dictate healthcare, and the results are a mess.  It's time to investigate alternatives.

2 comments:

  1. Asa Canadian let me share a different perspective based on two of your comments:
    > People only buy healthcare as needed.
    That's not true. Up here in Canada we're completely socialized in healthcare and therefore health services are perceived as being free (there's no charge to see a doctor, go to ER, etc). People abuse this left right and centre, going to the doctor for common colds and minor injuries that any idiot knows aren't serious because, well "just to be safe" which means "It's free so why not?"
    > substituting cheaper forms of healthcare doesn't always work
    But it does a lot of the time. Plaster casts are just as effective as fibreglass. Generic drugs are usually as effective as brand name. A nurse can give a shot just as well as a doctor. Diet and exercise are cheaper than insulin for some kinds of diabetes.
    > Market forces dictate that companies produce that which is the most profitable, not always the most necessary
    True, but market forces are driven by people. People who would rather spend money on cigarettes and pizza than All Bran and a good pair of shoes.
    > is still being treated with the same radiation and chemotherapy which have been used for decades despite their horrific and well-documented side effects.
    This is a terribly offensive statement which doesn't deserve a response.

    Garnel Ironheart

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  2. Regarding colds and minor issues--I took my kid to the doctor when she had a fever hovering around 101-102 that was kept under control with an OTC fever reducer. When it was five days and her fever was still coming back every time the acetaminophen wore off, I took her to our pediatrician. The diagnosis--pneumonia. As in "people die from that" pneumonia. The doctor prescribed antibiotics and she was fine, but had I treated it as a minor problem, I might not have my kid.
    Regarding substitutions--Yes, plaster casts are as good as fiberglass. Both are better than the treatment uninsured patients get, which is no cast at all. I had my head stapled after an accident by a PA. I substituted physical therapy for knee surgery. However, not everyone has those options.
    What's so offensive about the truth? Chemo causes hair loss, weight gain and sterility. This is well-documented. Radiation can cause cellular damage.

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