In a Forbes article that makes some questionable assertions about the mythical “free market,” Republican Chris Ladd explains why there really is never a free market, even from a conservative perspective, when it comes to health care.
In a statement that echoes what progressives have been saying for generations Ladd says, “Health care is not a market. It lacks any of the vital features of a market. Treating health care like a market means living and dying without modern medicine.” In spite of their otherwise undying fealty to an “unfettered marketplace” conservatives have danced around this and hacked together a “free market” system that comforts them and the moneyed interests who call the shots in American politics. But the reality is:
“The medical industry exists almost entirely to serve people who have been rendered incapable of representing their own interests in an adversarial transaction. When I need health services I often need them in a way that is quite different from my desire for a good quality television or a fine automobile. As I lie unconscious under a bus, I am in no position to shop for the best provider of ambulance services at the most reasonable price. All personal volition is lost. Whatever happens next, it will not be a market transaction.”
In putting a fine point on what is needed in America, Ladd inadvertently describes the system America lived under before Obamacare as well as the one we are heading to under Trumpcare:
“Absent a competent regulatory scheme, patients, at the moment in which they make their insurance purchase, have no way to be certain which provider will actually deliver on their promise. They will only discover the answer when their life, or the lives of their family members, depend on it. Under an insurance system without effective, powerful regulation, the market forces that would exist in a face to face transaction between consumer (patient) and supplier (doctor) disappear, replaced with a grim gamble in which the insurance company has every incentive to cheat.”
And cheat they did. Cancelling insurance when a paying customer got sick was a common occurrence. Denying coverage arbitrarily and developing a list of hundreds of “preexisting conditions” including things like acne, surviving domestic violence, and surviving rape was another method of controlling and denying coverage.
The solution from Ladd, a conservative Republican, is for Republicans to abandon their fetishizing of the free-market.
“One of the most frustrating obstacles to the growth of a broader entrepreneurship culture in the US is the structure of our health care system. It punishes innovators, chains employees to traditional work, and leaves millions of struggling Americans without access to care. We count on Republicans to deliver pragmatic, sensible solutions that foster a culture of business growth, but when it comes to health care Republicans are off their meds. Until the GOP is ready to move past their free market fundamentalist fantasies in health care and on other issues, our hopes of developing an ownership culture will remain stalled.”
Ladd rightly notes that the American healthcare crisis impacts all areas of free enterprise. Under Obamacare many were able to start businesses because they were finally able to get reasonable insurance as individuals rather than through employers. According to Deborah Gordon:
“A 2016 Harvard Business School Working Paper by Gareth Olds showed that the Children’s Health Insurance Program reduced the rate of uninsured children by 40 percent and increased self-employment by 15 percent, firm creation by 26 percent, and business share of income by 12 percent.”
“Logically, the ACA extends this premise. It not only expanded Medicaid coverage in many states — giving more children insurance coverage — it also improved market mechanisms for individual and small business insurance.”
Sadly the drive to assert their ideology over facts and logic is blinding many conservatives to the reality that prosperity for America depends on our nation providing for those among us who become sick. America lags behind almost every other major economy in healthcare outcomes while spending far more money. We get less, spend more, and suffer in many ways for it. This is not good for Americans of any political persuasion.
Progressives need to present these facts to conservative Americans. We need to invite them into respectful dialogue. We need to find common ground and appeal to their compassion. As the dismantling of Obamacare begins we need to show that this is not the way to greatness. Great nations, it has been said, are judged by how they treat their weakest members. Jesus speaks of the mercy of the Good Samaritan and we are reminded that he had great compassion for everyone. This is where we need to begin. This is truly how America becomes great.