Sunday, May 31

Health care is, and should be, a market

When cost of medicine for everyone falls on those who can afford it, nobody can afford it


Health-care costs are skyrocketing. People are going bankrupt paying for medical care. The government is certainly going bankrupt paying for it.

The United States pays more in medical costs than any other nation on earth and is no healthier for the money spent. Something needs to be done, but not what’s being done right now.

The general paradigm is that medicine costs too much because doctors, hospitals and Big Pharma are greedy. This isn’t quite true. Medicine is not something that grows on trees, that some people are randomly fortunate enough to be able to reach while others just cannot seem to stretch far enough.

Medicine is a business. It takes capital to produce and costs must be recovered. Like any other good, an amazing amount of time, effort, ingenuity and money were required to create even something as simple as aspirin. Imagine what it takes to develop effective oncology treatments.

Doctors and nurses don’t just wander into offices off the street. Physicians accumulate hundreds of thousands of dollars in debt and spend almost 10 years in training. Lab tests don’t vanish into the ether and come back a week later. They necessitate the time of a technician, the supplies for the test and the time of a phlebotomist.

Drugs aren’t miracles. Pharmaceutical development takes decades of research and clinical trials, millions of dollars in supplies and salaries, and countless failed ideas. Great ideas, the ones that dramatically improve convenience and quality of life, are driven at least partly by the motivation of profit. In a fair market, the more a product takes to produce and the more inherent usefulness that product has, the more it costs. Whole-wheat bread with flax costs more than plain white. We accept this. Yet, is there any other product more valuable to society than medicine? If we revoke the ability of hospitals and pharmaceutical companies to, at minimum, cover their costs, much less to make a healthy profit, we will eliminate the incentive and the means for them to provide medicine.

Health-care costs are increasing and they do not accurately reflect the actual expense of medicine. This is not due entirely to the greed of doctors and drug companies, but because those who pay the costs of medical care are additionally covering medical care for those who don’t pay. Imagine that I need a loaf of bread, which currently runs about $3 for wholesome and delicious wheat. We all need bread. It’s a food staple and without food, people would die. Let’s say that under a new system, grocery stores would be required to hand out loaves of bread to anyone who can’t afford them if they showed up with hands outstretched and they were hungry. The cost of the loaf (flour, packaging, transport, marketing, retail) still has to be covered, otherwise the grocery and the baker would go out of business. So instead of paying $3, which is right at the cusp of affordability for me, I have to pay for the loaf of bread for the next person too, who can’t afford it but needs it. This makes my bread $6.

Never mind the injustice of paying for something someone else gets for free, the bread is now far out of my means as well. Why would I ever pay more for something I could get for free? It’s in my better interest to claim I can’t afford it ““ and now that I have to pay double, I honestly can’t. This is exactly what’s happening with medical care. The uninsured seek and receive services which they cannot pay for, but which still cost money to supply, and the supplier must recover that cost somewhere else. Thus the premiums of the insured increase. The kicker is that the need of the uninsured for health care is exactly equal to the need of the insured for health care. If that’s the determinant for deserving something, then in that respect both parties have an identical right to health care. The fairest solution is either universal health care for absolutely every person regardless of income, or an entirely free market of medicine.

The proposed health care bill does nothing to change this problem. By imposing a surtax on people who are already insured to cover government health insurance for those who can’t afford it, the system still subsidizes the uninsured by placing an extra fee on the insured. The whole idea of taxation is that all taxpayers get back infrastructure from the government they couldn’t have provided for themselves. There should not be a small section of this nation that pays a tax which directly subsidizes another small segment of society but benefits no one else. The Founding Fathers rejected the idea of taxation as a redistribution of wealth.

The refrain that “it’s time for the rich to pay” is extraordinarily dangerous and in total opposition to the true spirit of this nation. We are guaranteed a right to life, but not a right to a specific quality of life. That part is listed under the “pursuit of happiness,” the opportunity to make our own way and improve our condition. The uninsured have a right only to minimal life-saving treatments, while the wealthy have the privilege of access to the finest doctors and newest therapies. This is how it should be; I can’t afford filet mignon and organic foods, so I buy ground beef and generic brands. I don’t feel that Bill Gates should provide me with a Whole Foods account so I can eat healthier. I am not the president, so I don’t begrudge Barack Obama the personal physician who follows him around everywhere he goes.

There will be no change from this bill. Those who can pay for themselves will still bear the financial burden of those who can’t, without getting anything in return. The only difference will be when and by whom the subsidy gets collected.

Pyburn is a third-year graduate student in pathology.

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