Competition and Medicine

First of all, I’d like to clarify a point that I tried to make in class today but kind of butchered. Sorry about that. Here’s the gist of it:

Assuming that a government has limited funds for their need-based healthcare program and will need to cut some types of care for some of its citizens, I think the quality of life the care would provide patients should be taken into account as well as the numerical data that some people in discussion today thought was emphasized too much in our case reading. Page 317 explains that donor organ recipients must be rehospitalized after their procedures on an average of more than one per case. These instances include “rejection episodes, complications from the operation itself, and infections that develop because such patients take drugs to suppress their immune systems to fight organ rejection, making them more vulnerable to other infections.” This description made it sound to me as if the risk of the procedures was not only quite great, but that their quality of life may be in some ways compromised compared to others who have had other procedures. I am not saying that this standard of life would not still be preferable to death, because I’m sure it would be, nor am I saying that taxes should not be raised in order to pay for these procedures. I do think that perhaps this should be taken into account if we are thinking about spending money on transplants at the expense of other procedures that may have less risks and be able to “cure” people more thoroughly, enabling them to maintain a higher standard of living. I agree with most of the class that these representatives should not have to choose; however, the political ideologies of the citizens and their representatives in Arizona (very libertarian, pro-states’ rights) does require people to choose and I think the total number of patients treated in the possible scenarios is not the only factor to examine when legislators are trying to make the difficult decisions of which care to fund.

One last interesting point that came up in class that I’d like to address is modifying the amount or means by which we pay our physicians to lower health care costs. I absolutely agree that the costs seem incredibly high, but I agree with a lot of people in the class that this shouldn’t be taken out of physicians’ wages. I disagree, however, that putting doctors on a salary rather than paying them for each case would benefit our current system. There are a lot of aspects about universal healthcare—and more socialist institutions in general—that I find very appealing. However, I am enough of a capitalist to see the benefit competition can provide for any market. If we pay doctors the same wage regardless of their job performance, they have no incentive (besides intrinsic motivation, which I would like to think would be enough but probably wouldn’t) to provide the very best care possible. Competition should also, hopefully, help weed out the worst physicians and improve the standard of health care in that way as well.