15 Years Later, The Healthcare Issues Are the Same
Bellow are some excerpts from the excellent article: "Health Care Reform: A Free Market Perspective," co-authored fifteen years ago (1994) by Harvard's Dean of the Medical School, Dr. Jeffrey Flier (MD), and featured yesterday on Greg Mankiw's blog:
Introduction: Problems with inflation of medical costs and increased numbers of uninsured individuals have resulted in widespread calls for reform of the U.S. health care system.
Proposed reforms have generally emphasized increased regulation of the medical and insurance industries, but disputes over the cost and consequences of these proposal has so far prevented legislation from being passed. This paper is presented from an alternative perspective that views the current symptoms on cost and access as the results of decades of flawed public policy, rather than government inaction (bold added). We trace the origins of dysfunctional health care markets in prior public policy, and outline an approach to healing the health care system based on a new dedication to free market principles and individual choice.
Licensure: Licensure, supported as a means to ensure physician competence and prevent fraud, has been an effective means for the profession to restrict its numbers and limit competition from alternative, often lower cost providers. Certification might work equally well, while authorizing increased services from an array or non-MD practitioners.
Conclusion: The health policy community has paid insufficient attention to the role of past policies in accelerating costs and diminishing access to insurance and has been too quick to recommend solutions based on optimistic projections of new regulatory efforts. Reform and aid to those in need based on free market principals are unique in recognizing the values of diversity and the desirability of choice in the highly personal realm of medical decision making. Freed of perverse incentives and regulatory obstacles, including those that would be exacerbated by much of the recently proposed reform legislation, markets in medicine, as in other areas, will outperform politics in making desirable health care available to Americans.
MP: I especially liked the section on licensure, a very refreshing viewpoint, especially coming from an MD. And speaking of allowing increased services from non-MD practitioners, I became aware yesterday that there is a movement in the field of dentistry to allow lower-cost dental hygienists to offer increased dental services like filling cavities. I think the American Dental Hygienists' Association is pushing for increased services for hygienists, but they are up against a very powerful trade group: the American Dental Association, which I think is resisting the change. I'll find out more and post about this later. If anybody has information about this issue, please let me know.
Originally posted at Carpe Diem.