Echoing the Economic Reality of Health
April 22, 2011 Leave a comment
The New York Times’ headline sums it up (Patients Are Not Consumers). Really, you don’t need to read much more if you’re convinced by the thesis statement. But, you probably aren’t. And another top economist that I listen to agreed in kinda the same way* on the Freakonomics podcast:
Healthcare] is virtually the only part of the economy where I can go out and get any service I want—cancer treatment, open heart surgery, have a wart removed, whatever it is—and I pay $3 for it or $5 for it or nothing, even if it costs $50,000 or $100,000. I mean, imagine if you had the same situation with automobiles. Where I could show up at the car dealership and I could say, ‘I want the Mercedes for free.’ Well, people say, ‘You can’t have the Mercedes for free. You have to pay $50,000 for it.’ You say, ‘Why not, I have an inalienable right to free healthcare. Right? Why don’t I have an inalienable right to a free Mercedes?’
Paul Krugman’s response to Republican calls to “make government health care programs more responsive to consumer choice.”
How did it become normal, or for that matter even acceptable, to refer to medical patients as “consumers”? The relationship between patient and doctor used to be considered something special, almost sacred. Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car — and their only complaint is that it isn’t commercial enough.
What has gone wrong with us?
Are we shopping for health? Do the sum total of our hospital purchases end with a customer satisfaction survey and overtly false good cheer from the middle management representaative at the hospital?
And for once, an economist offers solutions.
About that advisory board: We have to do something about health care costs, which means that we have to find a way to start saying no. In particular, given continuing medical innovation, we can’t maintain a system in which Medicare essentially pays for anything a doctor recommends. And that’s especially true when that blank-check approach is combined with a system that gives doctors and hospitals — who aren’t saints — a strong financial incentive to engage in excessive care.
This makes sense to me. Especially since my grandmother was put on a second round of chemo at her doctor’s recommendation. She got used to milk her medicare, and in the end, she’ll now die sooner, rather than later. Another doctor, horrified at her immediately decline, yanked her off chemo and excoriated his peer for essentially killing my grandma before the cancer would even get the chance to.
Would this happen in a system where “Medicare pays whatever a doctor reccomends”?
*And by kinda the same way, I mean he presented the same problem with the healthcare system: that shit gets paid for that people don’t really need and it’s causing a serious ethical diella. Instead, he came to a devastatingly wrong conclusion: that healthcare should not be a right.