- Jun 28, 2004
- 6,971
- 17,045
I am a bit of a policy wonk when it comes to healthcare and no matter you political leaning, it is important to bifurcate medical care and health insurance itself.
When it comes to health insurance, a free market approach is not very helpful if you define success as universal coverage. You need the wealthy and/or healthy to subsidize the poor and/or sick and the way to do that is to treat health insurance companies like regulated monopolies (like your utility company) or to have a single payer system. The worst parts of Obamacare are the result of insurance companies not being regulated.
Meanwhile, we have medical care itself. In that arena, competition and free market elements can be very helpful. There are aspects of medical care that need more market discipline. First and foremost is the process by which people get to become doctors. We have too few medical schools and too many barriers to entry. Unfortunately, Republicans never ask doctors to sacrifice and it is because doctors are, in practice, rentiers who just so happen to collect their above market profit from the healthcare sector.
The typical doctor is now the CEO of a firm that is built on the low paid labor of armies receptionists, medical billers (private insurance is just as bureaucratic as any government agency), nurses, technicians. The firm's capital consists of buildings and expensive medical devices. There are some heroic surgeons and some family doctors who do great work but increasing, the M.D. is just another useless capitalist fat cat. No wonder Republicans protect them from competition.
So if we made doctors compete in a more free market system and if we also allowed prescription drugs to be re imported at market rates, we could cut costs or at least contain the growth of costs of medical care. However, insurance is, even after Obamacare, grossly under regulated.
When it comes to health insurance, a free market approach is not very helpful if you define success as universal coverage. You need the wealthy and/or healthy to subsidize the poor and/or sick and the way to do that is to treat health insurance companies like regulated monopolies (like your utility company) or to have a single payer system. The worst parts of Obamacare are the result of insurance companies not being regulated.
Meanwhile, we have medical care itself. In that arena, competition and free market elements can be very helpful. There are aspects of medical care that need more market discipline. First and foremost is the process by which people get to become doctors. We have too few medical schools and too many barriers to entry. Unfortunately, Republicans never ask doctors to sacrifice and it is because doctors are, in practice, rentiers who just so happen to collect their above market profit from the healthcare sector.
The typical doctor is now the CEO of a firm that is built on the low paid labor of armies receptionists, medical billers (private insurance is just as bureaucratic as any government agency), nurses, technicians. The firm's capital consists of buildings and expensive medical devices. There are some heroic surgeons and some family doctors who do great work but increasing, the M.D. is just another useless capitalist fat cat. No wonder Republicans protect them from competition.
So if we made doctors compete in a more free market system and if we also allowed prescription drugs to be re imported at market rates, we could cut costs or at least contain the growth of costs of medical care. However, insurance is, even after Obamacare, grossly under regulated.
