Republicans and conservatives have long argued that free markets are the panacea for health care. (for that matter, they argue that free markets are the panacea for just about everything) I recently replied to a column written by a well known journalist who supported this approach to fix the problems with the Affordable Care Act. My argument in support of the elimination of markets was due in large part to the economic principle of inelastic demand. (my reply is the first letter in the list of letters)
In the comments sections, and in an email I received from the journalist in reply to position against markets, there is one standard reply in support of markets and it is this: “Market economics have proven remarkably productive, flexible, and innovative when it comes to food, clothing, and shelter. Food is even more essential to human life than medical care, and yet no one imagines that “it is time to take the delivery of nourishment out of the market.” And from others: Is food a right? Water? Clothing? Housing? Because without those things you wouldn’t have to worry about healthcare…you’d be dead. We need those things every single day and yet they’re very available, affordable, accessible, etc. For both rich and poor. Some will ask, “If the government has to give us medical care, what about food? Food is essential to life. Should food be free?”
To the question, “Should food be free?” I say, “yes.”, but a well qualified “yes”. If a citizen is unable to provide themselves with food, or clothing, or shelter, yes, the government needs to step in and provide food, clothing, shelter, or medical care – At NO fee- until such time as that citizen can provide for themselves. The government gives free shelter to its citizens when there is a wide spread power outage and the only safe housing is a local school gymnasium. There are countless examples of where the government freely gives food, water, shelter, clothing, and more, because of the citizen’s inability to obtain this from a market OR when the market cannot meet demand.
In addition to the principle of inelastic demand, as to why free markets are not the “fix” for health care costs, I will explain why health care is different from food, clothing, shelter and ought not be placed in the market. As I said to one person, “I can grow my own food, build my own shelter, weave my own cloth. When I can perform my own heart bypass, I will concede your point”
In 1900, the average American spent $100 (In today’s dollars) a year on health care. $100 a year is not a lot of money and so, as with clothing, food, shelter, most citizens could buy it on their own, without the help of government, and for that matter, without the need to purchase health insurance. However, in the late 1800’s and into the early 1900’s, fantastic advances in medicine were made. From vascular surgery, to anesthesia, antibiotics and more, medicine exploded with options to help treat, cure, and repair many physical ills that beforehand were either a death sentence or life long agony.
In 1900, the average American’s health care cost $100 per year. Today, that figure is over $8,000. It is important to point out that $8,000 is an average. Most citizens are in need of far less than $8,000 but some citizens will need much much more at one time or another. Heart bypass surgery typically costs about $70,000-$200,000 or more, and heart valve replacement surgery typically costs $80,000-$200,000 or more. If we were to budget the total cost to support two individuals from birth to death, we could easily calculate how much each would need in terms of food, clothing, shelter. We all need about 2,000 calories a day, and so on.No citizen is that much different from another with regard to food, clothing, shelter. However, it is impossible to say, with certainty what medical treatments either person may require. It is also foolish to assume that most anyone could or should save money for heart valve surgery or chemotherapy.
As I noted earlier, if a citizen is unable to provide themselves with food, or clothing, or shelter, yes, the government needs to step in. The same is true of health care. Given that the cost of health care is potentially so high that few citizens could ever afford it on their own, and given the reality that only a few will need very expensive treatments – but we do not know who among us that will be- it is only rational, equitable, and moral that our government provide medical care to its citizens in same way it provided that school gymnasium to the local citizens in need who could not provide for their own shelter.
Or, is the Republican conservative reply to those citizens to “buy your own school gymnasium” in the free market?