What if the free market chose something that looked more like "socialized medicine" — and it worked?
One of the persistent health care reform canards is that the free market will produce better-quality, lower-cost medical care than "socialized medicine." (Socialized medicine seems to mean any system that involves the government or seeks to reduce the 70 percent of the health care dollar paid to middle men and pharmaceutical companies.)
Well, the free market has not done all that well for America, since we have higher costs and more middling outcomes than other more socialized systems. (Cue Jeff: "It's not a free market!") Nor has it produced anything approaching consistent performance across the country. The New Yorker article looks at similar western states markets and finds very divergent outcomes and costs.
From the post at Growth & Justice blog:
The difference between McAllen [Texas] and Grand Junction, Colorado, one of the nation's lowest-cost markets with some of the highest quality-of-care scores, may be the difference between a culture focused on money versus one focused on a healthy community.
Or, one might say, on the individual entrepreneur over collectivism.
Over the last two weeks, I've had three illustrative and distinctly different experiences with health care delivery systems.
In one, I accompanied a cancer patient who spent a frustrating three and a half hours in a not very busy hospital ward, waiting for a piece of equipment we didn't need to administer a routine treatment. It should've taken half the time, and I can't even imagine how much it cost. After a series of these experiences, and based on his own initiative, he now has a $90 do-it-yourself setup he can use at home.
Also this week, I interacted with two veterinary clinics and received, without asking, cost estimates for a range of potential treatments before I made a decision for a gravely ill pet. An example of consumer-driven care? Hardly. Circumstances didn't allow price shopping and more cost information didn't make me a smarter consumer of the services offered. It actually complicated the decision process and made it difficult to relate to a new clinician who started out talking about costs instead of the patient.
Finally, in a testament to the article's claim that care in Grand Junction is more patient-focused, I called a clinic there and spoke to a physician there who had seen me only one time regarding a throat condition that was already starting to heal on its own. Over the phone, I was able to get two medications prescribed here in Minnesota to treat a flare-up that occurred right before I was to sing at a wedding. And he received no payment for taking my call.
The free market has certainly allowed experiments like the Mayo Clinic and Grand Junction's "accountable care" models to emerge. But it also is spawning more money-oriented medical cultures like the one described in McAllen, Texas, where one doctor said of consumer-choice models: “Any plan that relies on the sheep to negotiate with the wolves is doomed to failure.”