This one is a few days old. Don Boudreaux writes in the Pittsburgh Tribune.
As I’ve argued before in this space, one result of this unduly heavy reliance upon third-party payers is that almost everyone who consumes medical care does so irresponsibly. That is, the typical American is unresponsive to the burdens that his or her medical-care choices impose on others. This unresponsiveness — this irresponsibility — exists because we’ve socialized too much of the costs of medical care. Why should I give close attention to the price of some recommended medical procedure if I, personally, am paying out of pocket none (or only a tiny fraction) of the price of that procedure or drug?
With everyone irresponsible, resources are wasted. And with massive waste comes unnecessarily higher costs.
It’s a mystery why medical care cannot be supplied in the same way that, say, accounting services and food are supplied. Like medical care, these things are valuable. (Indeed, food is even more essential to life than is medical care!) Also like medical care, some types of accounting and some types of food are more crucial than are other types — and accounting services and food are supplied on a fee-for-service basis.
And yet, America suffers no “accounting services” crisis or “food supply” crisis.
But, you may say, health care isn’t like food or accounting services, and trade off choices aren’t the same when we are talking life and death.
Some proponents of the idea that medical care differs so much from other products that it cannot be compared to things like accounting or food say that “in matters of life and death, people aren’t willing to make the trade-offs that they make when deciding how much of other things to buy.” The idea is that a person on his or her deathbed will not care about the price of the costly medical procedure required to prolong life.
This “deathbed” tale is likely true. But it’s difficult to see how it counsels that we socialize medical-care payments. Does anyone seriously suppose that decisions by government bureaucrats over who will get, and who will be denied, some expensive lifesaving procedure would be better than having such decisions made according to each patient’s willingness and ability to pay?
In either case, some people will be denied care. I’d prefer that the impersonal forces of the market direct such decisions than to have them made by bureaucrats. Each of us, at the end of the day, has more control over the size of our bank accounts than we have over politically influenced bureaucrats.
And there, friends, is the rub. The fundamental question is: Do you want someone else making health care decisions for you? Do you want the government making those decisions?
Or do you want to be free?