How Free Market Economics Can Save Healthcare
December 7, 2012 in Health
The healthcare system in its current form is complicated. It is a web of complex terms: deductibles, co-payments, networks, HMOs, ICD-9 codes layered in with all the medical terminology, it is nearly impossible for the average person to navigate the system without getting some sort of higher degree. Now with the introduction of Obamacare, it seems to be getting even more complicated as the book of rules regarding what we can or cannot do or buy grows larger and larger.
But even in this jungle, at the end of the day, healthcare is simple. What it comes down to is two people: the doctor and the patient. Back before medicine sold out to corporate interests, you called up the doctor when you were sick, he came over with his back of equipment, gave you some medicine, and in return, you gave him some money. Simple. That core relationship is why we got into medicine, it’s what patients desire, someone who cares about them, who is real with them, who will tell them the truth about their health. And anything that gets in the way of that relationship is counterproductive to what we stand for.
The reason why our healthcare system is so complicated is because there are so many things that stand in the way of that fundamental relationship. There is the ACO that pressures doctors to increase their bottom line, there is the pharmaceutical industry that pushes doctors to unnecessarily prescribe harmful drugs, there is of course the government.
So lets simplify it. Lets bring it back to what it used to be: a doctor and a patient and nothing else. This philosophy on medicine is called Direct Primary Care, and it represents the healthcare arm of the liberty movement and it is the best way to acheive health freedom. Simply put, the patient pays cash to his/her primary care physician and he is free to give the best, unbiased medical care that he was trained to deliver. Fee structures are highly variable and can range from $250 to $2500 per year. Usually, patients will choose to get a high deductible health plan (HDHP) coupled with a Health Savings Account (HSA) to cover catastrophic care as well as to cover lab tests and imaging tests.
Direct Primary Care is free market. Under this system, doctors would compete with each other over patients and this competition would drive the best quality at the lowest prices. If you were a bad doctor, one who doesn’t see his patients promptly, whose patients continue to suffer from chronic disease, who doesn’t offer alternative treatments, then patients will leave and find someone else. Consumers will figure out how to review doctors in a public forum and patients will be able to make informed decisions about which doctors they choose. In turn, doctors will discover new and unparallelled freedoms and release the shackles that have prevented them from having that strong patient-physician relationship. Patients would have a strong desire to improve their health because they would see their payments to their physician as the purchase of a service they should take advantage of, in a similar manner to the phenomonen that joining a gym makes you more likely to work out.
Primary care should not function as insurance. Insurance is something that you should ideally never have to use. You wouldn’t buy home insurance with the expectation that your house would get burned down once a year. So Direct Primary Care is not a rejection of health insurance in general. Unforseen acute medical emergencies should work on an insurance basis, for example, getting hit by a motor vehicle. But primary care is something that you should buy to make you healthier and is something that you should want to utilize as much as you want or need to.
Direct Primary Care is not just theoretical, it is practical, and the number of DPC practices are growing rapidly and thriving. In a way, it is going around the system that in many ways is a medical tyranny. It is a model that our Founding Fathers would have supported, a system that is rooted in the simple principles of free market capitalism that made our country the freest and most propserous nation in the history of the world. And if the liberty movement is to move forward, direct primary care must be central to the world we try to build. We must reject the false paradigm that the government is responsible for taking care of us in every aspect, and allow for a new age of personal responsibility and freedom.