Thank you Paul Krugman! You’ve made an excellent initial point in your post: Patients are not Consumers - http://krugman.blogs.nytimes.com/... Don’t stop there, though; please go farther.
Please say that since patients are not consumers and are not making ‘economic’ decisions, that the ‘market’ for health care is greatly an imperfect market. Please say that when a market is imperfect, rather than directing resources to the most efficient producer, it funnels resources to the most economically powerful players in the market (insurance and drug companies) and away from individual consumers. Please say that this explains the drastic and unceasing increase in healthcare costs. Please say that the hobbling of Medicare (through the prohibition against bargaining imposed by ‘Medicare D’) shifted they economic power further toward the ‘for-profit’ healthcare insurers and providers. Please say that the Ryan plan completely eliminates the economic power of Medicare by breaking it up into millions of pathetically weak individual market actors. Please say that when Seniors are forced to buy ‘supplemental’ plans (to make up for the inevitable disparity between what their ‘coupon’ will buy and what the market will charge) the system-wide resources spent by individual providers in their attempts to get other providers to pay will skyrocket. Please say that these ‘payment avoidance’ costs are ‘waste’ which already explains much of why our system already costs more than any other nation’s healthcare system while delivering care which is measurably worse for the vast majority of our population.
Please say that a wildly imperfect market is an unwise choice as a mechanism to allocate resources – that it fosters bad decisions and poor resource allocation. Please say that when a market is so essentially imperfect, it is economically wise to abandon market solutions.
Thank you for mentioning the deeply immoral core of the whole idea of a ‘for-profit’ health system. Not only is our system wildly inefficient, it is disgustingly unjust, greedily dissolute, and structured so that the strong to prey upon the weak. Please mention that our current system is NOT disproportionally enriching our health care providers (the doctors and nurses who labor diligently for our benefit from motives rightly of benevolence and professionalism more than greed and self promotion). Please mention that our current system does disproportionally enrich the idly wealthy through betting on either our collective health or distress.
Please mention that ‘health’ is a societal ‘good’ - that no one ever caught strep-throat EXCEPT from another member of our society and the we thus benefit from the good health of our neighbors and fellow citizens. Please mention that ‘disease’ is societal waste in our economy – that poor health is an expensive drag on our economy as a whole. Please mention that the promotion of the ‘general welfare’ is a core function of government enshrined in the very first sentence of the Constitution - that governments in every other advanced economy on the planet have solved the economic impairments to their healthcare systems through non-market systems which are measurably superior on an economic basis.
You’ve stated the fundamental (but largely ignored) truth at the core of the economics of healthcare – that a ‘consumer-driven market-based model’ is a poor foundation for a healthcare system because patients do not behave economically like consumers. Please continue down this path; explain the dysfunctional economics at the core of our deeply flawed system. Your gift for explaining complicated economic concepts in a lucid and logical way are desperately needed when the dominant media fails so miserably at ‘informing’ in favor of ‘selling’. Please continue and expand your arguments and follow them down their logical path. The health of the nation lies in the balance.