Healthcare Daily Digest for Wednesday, 6 March: Is the Free Market the Best Steward for Healthcare?

The free market is supposed to save us all because men with expensive haircuts and even more expensive suits tell us that frequently because of capitalism and Too Big to Fail! and all of that nonsense.

But what if the free market isn’t what’s going to save us? Especially when we’re talking about healthcare?

As Frederick E. Allen points out in Forbes.com blog piece: “A typical consumer may need virtually no health care for decades and then suddenly be stricken with something that will cost hundreds of thousands of dollars to treat. At that point he is likely to be unconscious or severely disabled and unable to make free-market choices at all. Even in the best of circumstances he can’t know how well a particular treatment will work or what further purchases may necessarily follow or how much it will all end up costing. Comparison shopping is usually out of the question. Meanwhile the market encourages doctors and hospitals to do as much as possible, and insurers to pay for as little as possible. The free market consumer is virtually helpless. He can do well in relatively low-cost elective matters like Lasik eye surgery or cosmetic dentistry, but not in the high-price emergency situations that cost so many times as much and that virtually all of us eventually face.”

There’s a line from Macbeth — heartbreaking, if you can find some empathy in your heart for a brow-beaten kingslayer — where he explains “I am in blood/Stepp’d in so far that, should I wade no more,/Returning were as tedious as go o’er.” By which I mean to suggest: the current system of healthcare we have may be too broken; too incestuously intertwined with commerce and insurance companies and pharmaceutical companies. We may need to start from scratch.

Wednesday’s headlines:

• The Wall Street Journal’s in Dutch with Readers: “As I reported in January, the publisher of the Wall Street Journal and others are suing to gain detailed access to Medicare billing records through the Freedom of Information Act. Off-limits to the public since 1979, such data could hold the key to billions of dollars in savings, once journalists armed with modern technology sift through it for evidence of waste, fraud and abuse. Doctors are fighting the lawsuit, claiming that their taxpayer-funded earnings are none of the public’s business.”
• Technology as Vehicle for More Personalized Care: “While today’s buzzword in health IT might be population health management, Eric Topol, MD, director of the Scripps Translational Science Institute, believes that medicine needs to be practiced at a more personalized level.”
• The Answer to This Headline’s Question is a Resounding NO: Should Healthcare Be More Like Airline Industry? “What could healthcare learn from a financially strapped industry that people love to hate? It’s the fact that U.S. commercial airlines carried 52% more people in 2010 than they did in 1995, and yet they employed 2% fewer people. It’s that airlines did away with unprofitable luxuries such as meals in coach and filled excess flight capacity. It’s that airlines shed lots of jobs at front counters and reservation call centers and replaced them with kiosks and online bookings.”
• Maybe There’s a New Frat to Pledge?: “Change Healthcare, a provider of consumer engagement and cost transparency, announced the launch of Healthcare University, an interactive series of educational videos, quizzes and challenges that leverages game mechanics to teach consumers the basics of healthcare and how to make value-based healthcare decisions.”
• An Important Question with No Clear Answer: “What It Will Take to Achieve Healthcare Coverage for the Poor: Public-Private Partnership.”