It’s lovely and refreshing to be back at work after a national holiday of eating, singing off-key and blowing things up. In the bunker, we’ve had a spurt of columns and comments about the Supreme Court’s slippery upholding of Obamacare, which has ended(?) a two-year battle about socialism and death panels and man’s inhumanity to man and contraception. We’re grateful to move on today to everything else that’s wrong with health care in America, even if the Affordable Care Act works perfectly and immediately.
Fareed Zakaria’s column today covers just that. He suggests, with agreement from experts, that the free market just doesn’t work to provide the best outcomes in the arena of medicine. So while Obamacare tries to soften the harder edges of a capitalist system of health by forcing insurance companies to keep people it would be cheaper to drop and lower their percentage of profits, that won’t solve a different, enormous honking problem: Americans, in the aggregate, are lazy, poor idiots who want to make their own choices but can’t be trusted to make the right ones.
Capitalism, Zakaria argues, has made of health care a big ol’ inefficient wasteful system that (when compared with other modern democracies) delivers less result for more money. Socialized medicine in France, for example, is cheaper and has better outcomes. And capitalism thrives on cost efficiency. So, argues Zakaria and a free-market medical expert he quotes, in this case some degree of socialism would be the best capitalist solution! How’s that for fireworks, America?
Many commenters agreed with Zakaria that pure capitalism is failing at health care.
RHAMS says it’s because health care itself is such a weird commodity:
If a plumber does work at your house and doesn’t fix the leak, you won’t pay him. However, physicians and hospitals get paid for expensive treatments even if the patient dies.
Wpadude agrees and brings out some big capitalist guns to back it up:
Charlie Rose interviewed Bill Gates recently. Bill explained that market forces fail in two circumstances: when the cost of innovation or research is high, and when the market is poor. He said this in the context of getting drugs against prevalent diseases such as malaria. It will be very expensive to develop such a drug — so it’s unlikely that the market will lead such an effort — and the customer base for such a drug, although very large, has very limited ability to pay for it to make it profitable. The free market will not develop a malaria drug. He concluded that we need government to fund basic research and philanthropy to provide the drug innovation, the efficiency and the distribution.
Other commenters argue that it’s because America itself is such a weird country:
Nick212 sees this in laws as well as markets:
There is little, if any, concept of responsibility for your fellow citizen in the Constitution. That was supposed to be left for your spiritual values. And indeed, 200 years ago that did seem rather a logical division.
Under American law, you can watch a person drown without recrimination. Under English common law, that is a felony.
MadiganT agrees that America is different.
We’ve decided centuries ago to be a society of individual choices, and when those choices are bad, only the individuals are to blame, not the providers or the owners of those services.
HealthcarePolicyWonk suggests a new mode of attack on the current system:
Important to remember that most of the rest of the world controls the prices charged by physicians, hospitals, drug, and device manufacturers. Change the payment system for physicians and hospitals and you’ll get a very different (and better) result.
And killroy71 says that socialism and capitalism can and do work side by side:
In Great Britain, private insurance offers faster access to higher quality care than offered by the “basic” national system. In other European countries, the govt relies on private systems to actually administer uniform policies — the health plans compete on service not price.
PostScript does believe we’ve all just solved it. Socialism and capitalism — two great tastes that taste great together. We want a government to save our lives after we were hit by a car on a bike lane Congress provided because it saves the country money by keeping our hearts healthy. And we want to buy physical therapy rehab in a nicer facility with shorter waiting periods so we can get back on the bike sooner.