How is the Health Care System Broken?

The phrase "We all agree that the system is broken" has become common in the health care reform debate. Politicians and commentators invoke it to show that we have a common value or belief that should compel us to desire reform. The phrase has been used to justify every type of reform on the table. But in truth, we agree on very little about this 'broken system.' We can't even agree on what 'the system' is and much less how it is broken.

Imagine a professional basketball team that has trouble winning games. They have defensive and offensive strategies that they prescribe to and develop a rotation for the players. Despite their efforts, they are not winning. The players come to an agreement. "This is not working. We need a change," they tell each other.

But what is not working? Some of them are referring to the defense. Some of them are referring to the offense. Some of them are referring to their player rotation. Little does the team understand, but several of the players are even referring to the sport of basketball. When they say it isn't working, it's because they want to give volleyball or soccer a shot.

Such is the situation in our country. People say the system is broken. But what they mean varies. Some are speaking of the health insurance industry. Some are speaking of the high price of health care. But we are surprised to find out that many refer to the American standard of economic freedom. They suggest that we ought to be playing a whole new game.

Like everyone else, I have my own opinions as to what is broken in the American health care system. I could write pages (I have written pages!) about interferences in the patient-doctor relationship, the money wasted on the insurance industry, and about how government and insurance involvement in the market create artificially high prices. But there is one 'system' that is definitely not broken. There is one 'system' that keeps the industry afloat despite all other missteps. That system is the American 'system' of a free market.

If we are more precise in our description of a free market, we cannot even call it a system. The free market is the state of the economy in a free nation. In a free market there is no government organization that coordinates buying and selling. There are no laws about how much of a product someone can buy or how much it can be sold for. The free market is the economic result of a nation recognizing the God-given, inherent rights of humanity. It is a natural state that allows the rise and fall of man based on his actions.

Anyone involved in the medical field can see that the above description of the market does not completely fit the medical industry. A huge part of health care really has become a government system. There are huge government organizations- Medicare, Medicaid, and even the FDA- that coordinate buying and selling. There are laws governing who can buy health care products and how much they can be sold for. There are laws in place that do not allow man to rise and fall based on his actions, but attempt to enforce a universal mediocrity. In these ways the medical industry has become a controlled system.

However, much of the medical industry is still free- it is not systematized. It is this part of the industry, the free market, that keeps all the rest afloat. The market responds and equilibrates when the federal government refuses to completely reimburse doctors for seeing Medicaid patients. The equilibrium is achieved by paying patients being charged more for their health care. The market responds to FDA regulations on the pharmaceutical industry that make the development of new, lifesaving drugs cost over one billion dollars per drug to develop. The market equilibrates as patients pay incredibly ramped-up prices to pay for the hoops drug-makers must jump through.

It is the free market, and not systematized government intervention, that has brought many recent cost-saving innovations to the market. Surgical centers are popping up all over the nation that perform surgeries at a fraction of the cost of local hospitals. Lower prices for healthcare are appear as midwives, physician assistants, and nurse practitioners become more available. They provide competition that also brings down the price of local doctors. Wal-Mart recently rocked the pharmacy industry by launching their $4 prescription plan, making hundreds of essential medications available for $4 a month. Competing pharmacies nationwide responded immediately by dropping their prices. These and many other occurrences in the free market have helped keep health care afloat despite all other system interventions.

So perhaps we do agree that the system is broken. It does need to change. It needs to release its death-grip on the medical industry and the free market. Sacred freedoms must be preserved and the market must be obstructed. If freedom of the market is preserved and enthroned, health care prices will go down. Patient access to doctors will increase. The poor will be able to afford health care. Health care will not just survive or stay afloat, but thrive.

Rusty Scalpel