In North America, we find ourselves on the precipice of a new political climate, one that promises to level the playing field between corporate greed and the “average Joe”. Where this applies to the healthcare services market, what’s the correct approach to improve the level and quality of service without introducing the inefficiencies and, frankly, ineptness of government's attempt to fix anything? Is it really caring for the “average Joe” to artificially limit normal market forces which have been so imbedded in our democracy since its infancy?
A recent Wall Street Journal article reports that the U.S. Congress is attempting to provide more low-income children with health-insurance coverage by limiting access to doctor-owned healthcare facilities. While providing healthcare coverage to children is a very worthy goal, if our ultimate goal is increasing the level and quality of service to individuals seeking healthcare services (whether paid for privately or by some third party), why limit any access to those providers that may provide a better quality of service than someone down the street? Does Congress just assume that they are better qualified than an educated consumer to choose the best healthcare "product"? Where's the evidence to qualify their thinking?
How about an analogy to prove the point? Let’s say you are walking the streets of Manhattan and looking for the best hot dog available. You know from experience that the Acme Hot Dog Corporation has the biggest hot dog stands around but based on your experience, you know that in comparison, Hank’s hot dogs on 46th street consistently provides the freshest buns, best tasting condiments, and never before have you ever chipped a tooth on material other than meat. The Acme Hot Dog Corporation however, with much less demand for their substandard hotdogs, appeals to the City of New York to stipulate that Joe’s stand be allowed to operate on Tuesdays and Thursdays only to “level the playing field”. Isn't this an accurate analogy for government’s attempt to fix healthcare?
Granted, some doctor-owned hospitals may have motivations at play other than the quality of service to patients but in our market driven society, wouldn’t those facilities eventually be culled due to normal market forces? I would contend that where there are the exceptions of motivations other than providing the best quality of service to individuals, those motivations and ultimately the providers will succumb to word of mouth anyway. Should we allow a government without a consistent track record of managing services (other than protection) to its people really be allowed to make rules based on the exceptions?
It seems that we have two issues to solve here. One is providing access to quality healthcare services to those who can’t afford it and two, incorporating - not eliminating normal market forces that have worked for decades in our efforts to accommodate One.
The other obvious eight hundred pound gorilla to change is the third-party payor system that sometimes dictates the level and quality of healthcare services. That’s for a later discussion.
Most of the problems associated with government’s attempt at leveling the playing field have yielded less than stellar results. Shouldn’t we try to incorporate a new approach to expect different results?
"I cannot say whether things will get better if we change; what I can say is they must change if they are to get better."
George C. Lichtenberg