Indiana Governor Mike Pence is adamantly opposed to the expansion of Medicaid in Indiana, despite the fact that his opposition will cost Hoosiers a lot of money–not to mention lives.
When Pence announced his negotiated one-year “deal” with the federal government to continue “Healthy Indiana” in lieu of expanding Medicare (a “deal” that leaves some 400,000 Hoosiers without healthcare), he insisted that “Consumer driven healthcare is the path to the future.”
Sorry, Mike–but if that’s the case, the future is pretty damn bleak.
Here’s the problem: markets work incredibly well when buyers and sellers operate on a level playing field. They work especially well when consumers are looking for widely-available goods and services, and can compare prices and quality and shop around for the best deal. Economists define a market transaction as one involving a willing buyer and willing seller, both of whom are in possession of all relevant information.
That description does not remotely apply to medical care.
The “consumer” who needs a hernia operation is highly unlikely to be in a position to shop around. He’s much more likely to need immediate care, and be locked into using a particular provider by his insurance company. And he is highly unlikely to know as much about the procedure as his doctor.
For that matter, this “consumer transaction” isn’t going to be negotiated by the patient and his doctor. The real parties to this transaction are the doctor and the health insurance company–and as recent news reports have reminded us, the needs of the patient are rarely front and center. (The Star recently reported on a lawsuit brought by the widow of a man who needed a pacemaker–despite the urging of his own doctor and another doctor who was consulted for a required “second opinion,” the insurer delayed its approval, and the man died. The doctor insists that, had his patient had a timely procedure, he’d be alive today.)
There is no market in health care. There never will be. Hernias and heart attacks aren’t widgets and mousetraps; there is not and cannot be a level playing field where consumers have as much information and power as their providers–or where their providers have as much power as the insurers. Other countries have figured that out. And in those other countries, amazing as it may seem, big bad evil government has turned out to be more protective of patient needs than for-profit insurance companies beholden to their shareholders.
To suggest that “consumer-driven” healthcare is the future is to display profound ignorance of market economics.
I think it’s interesting how many “free market” ideologues like our governor have no idea how markets really work.