Healthcare Cannot be a Free Market

Photo by Pictures of Money


How much is a human life worth?

Any answer that attempts to put a monetary value on a life, to suggest that one life may be worth more than another, is repulsive; yet the Conservative ideal that healthcare should lend itself to the free market, free from government regulation and intervention, attempts to do just that. The hope that healthcare could, if left to its own devices, self-regulate and offer cheaper, better, universally accessible healthcare as free markets ought to do is fundamentally flawed: healthcare cannot and should not function as a market.


Surgeons don’t have specials on appendectomies


Markets are governed by the negotiation between supply and demand, with one adjusting to the other until an equilibrium is reached: when fracking produces more oil, the price goes down and people buy more SUV’s to guzzle all that cheap gas. The demand for healthcare does not change with variations in price: surgeons don’t have specials on appendectomies and if one is needed the patient isn’t in a position to negotiate. The obvious answer to this problem would seem to be insurance. With insurance you pay regularly when you’re healthy so that when you are hit by a bus or lying in a hospital bed you won’t have to shop around for ambulances or negotiate the price of your MRI. Here, though, another flaw emerges: the interests of insurance companies are not aligned with the interests of their customers; the value of the customer’s life has a finite value to an insurance company and negotiations will be carried out with this in mind. An insurance company will pay for that MRI but may not pay for a specialist to give a second opinion, it will pay for childbirth but may force a mother out of the hospital a day later, it will pay for opioid painkillers but if you become addicted rehab is on you. A free market works because goods and services are allocated through transactions based on mutual consent, but when one party is unwilling or unable to negotiate for their well-being, future, or life they are left at the mercy of an entity with interests that conflict with their own. Insurance companies don’t get cancer and insurance companies don’t have to feed your kids.

The vision for free market healthcare often refers to greater competition between insurance providers as a means for improving availability and quality of coverage, but insurance companies are left with little more choice than their customers in the treatment necessary and the market forces guiding them. The demand for services does not depend simply on the desires of the patients, but is primarily determined by accidents, fate and the judgement of medical professionals. Likewise the supply of these services is limited by the high standards and even higher costs of entering the market, such as medical school, research, and the necessary equipment. Finally, the inherently unpredictable nature of medical care added to a lack of transparency in prices makes it nearly impossible to accurately estimate the cost of a healthcare transaction.


A market must have winners and losers in a Darwinian quest to filter out the weak, but in healthcare the weakest party is the only one that matters: you


With both supply and demand in healthcare inherently inflexible, it is nearly impossible to complete a transaction that will satisfy the needs of all parties involved: the healthcare provider and the insurance companies enter into negotiations and an agreement is reached often at the cost of the patient. Equilibrium in a healthcare market can only be found by placing a monetary value on human life and well-being, and there is no average between the unlimited value placed by the individual on their own life and the very limited one given by the healthcare provider, based on the willingness and the ability to pay of the insurance company, and by the insurance company based on the ability to pay of the customer. A market must have winners and losers in a Darwinian quest to filter out the weak, but in healthcare the weakest party is the only one that matters: you.



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