Thoughts on Market Based Medicine

Lately I've become really tired of the constant onslaught of fear based politics of the right wing of Government sponsored Healthcare in the United States. I had a recent epiphany of the medical care system that I think really sums up the overall experience of market based medicine in a nutshell.

Well, the epiphany came about based on a recent experience a friend of mine had. You see, apparently while driving down the freeway at 50 miles per hour with ones arm out the window has the tendency, or possibility to - well - be ripped off my large metalic objects one tends to pass on the freeway - that is - other cars driving too close to ones own.

Well, according to market based philosophy: Whenever one needs a good or service, it is ones responsibility to become aware of the multitude of options available to you, compare the different benefits, drawbacks and prices available, and them come to a rational conclusion.

Well, the trouble is, when one has their arm severed from their Torso, or they suffer from a stroke or heart attack, or encounter another issue requiring immediate medical attention market-based rationality goes completely out of the window. It is completely illogical and life threatening to call emergency rooms to shop for the best facilities, the lowest cost, and the availability of options. The reality is that the most logical option is to go to the nearest available facility able to save your life and get there with the utmost haste.

Obviously, any rational individual wouldn't be willing to risk their life to drive to another hospital down the road because of the urgency of the needed medical care. I'm also hard pressed to imagine that my same friend with the severed arm would be willing to sit down with a phone book, and one arm, to telephone each of the competing area hospitals to determine the best option available to him.

Well, this leads to quite the paradox: Each consumer only has one readily available option to them in an emergency situation: the closest medical facility. This puts the medical facility in a very enviable position: they get to determine exactly how much your life is worth. They are just as easily able to charge $10,000 as they are $10 Million dollars for the medical care that you receive. Your options are to either accept the medical care cost, or die. Clearly the best soluion is to accept whatever price is offered. Thus, in the absence of rational consumers able to make choices, markets simply don't work for emergency medicine.

But do they work for other areas of medicine too? No. Let me explain.

Well, I recently had a medical situation hat required me to see a dertmatologist in the Oklahoma City area. (I live in Albuquerque). I tried to work with my insurance company to find a local provider of dermatology services, and discovered that the average wait time to obtain this care is about 5 months here. Fearing I would need to suffer needlessly, and the opportunity to interview with a company in Oklahoma City led me to leave the Albuquerque area and visit a dermatologist while I was there.

I called a dermatologist there that was recommended by my insurance company and booked an appointment to see them. I made it to the dermatologist with only one weeks advance notice, asked a plethora of questions and got the prescriptions I needed without a problem. The real trouble began when my insurance company found out I went to a provider that was out of state but was IN the insurance companies out-of-state approved provider list. Today I received a letter (05/17/2008) stating that I could be billed for over $800 in services rendered by the dermatologist despite going out of my way to find an approved vendor by my insurance company. So, it seems the market has yielded two different choices: Pay $650 in health premiums and wait 5 months for service from a dermatologist, OR, Travel out of state, pay $200 in gasoline, $100 for a hotel room, $100 for restaurant food, and another $800 for dermatologist appointment ($1200) for a lousy dermatology appointment.

So, if the market doesn't work for emergency services, doesn't work for routine medical care, keeps people away from their doctors and specialists so they cannot receive medical care, why bother paying any health premiums at all?

The kicker here is if I were an illegal immigrant I would have received all the above medical services for free. Why bother doing the right thing?