Conservatives now pushing to replace the Affordable Care Act with some version of the concoction commonly derided as “Trumpcare” regularly talk about how we can have better, more affordable health care by getting government out of the way. The “free market,” they tell us, will make everything better if simply left alone to do so.
What utter horse-puckey.
The essence of free market theory is that consumers vote with their dollars, forcing companies to compete by offering better products or services for less money. That works fine in some circumstances, but health care is not and can never be one of them.
If you doubt me, let’s look at one area where consumer choice does pretty well: Purchasing a car or truck:
You don’t need to be an automotive engineer to figure out what general type of vehicle you need. If you’re single and just commuting to work and going out on the occasional date, that suggests something quite different from hauling the kids’ sports team and their equipment to practice, or packing up the camping gear for a family wilderness adventure.
Once you’ve gotten that far, you can find nearly endless information on the performance and reliability of various makes and models, most of it written to be used by ordinary consumers. You can look up government and insurance industry crash safety data, check mileage stats and resale value. Any number of publications will offer you driving impressions and road test data.
And of course, you can go to your local dealer, sit in the thing, take it for a test drive, and determine if it feels right for you. It’s all pretty simple, no special expertise required. And having found the car or truck you want, it’s not to hard to contact multiple dealers and see who’ll give you the best price.
Okay, now let’s try this process of informed shopping to make a decision on something different: How about … brain surgery?
See the problem? Almost none of us has the expertise to even know what questions to ask about such surgery, or to have the remotest idea of what would be a “reasonable” price for the operation we’ve decided on. The “magic of the market” has no chance to play any role. None. Zip.
Ah but what about shopping for health insurance? That, some say, is where the free market will work its magic.
Uh, have you ever read your health insurance policy? Did you understand it?
One great improvement the ACA made was to make it far easier to comparison shop for health insurance. By requiring plans to include a defined set of benefits that cover most people’s medical needs and setting up a series of tiers (Bronze, Silver, etc.) with clear, understandable differences in things like deductibles, Obamacare finally made shopping for health coverage a somewhat rational process in which consumers could reasonably exercise their right of choice to at least some effect.
Still, even with that significant improvement, the high cost of insurance means that most buy the best they can afford, rather than what they really need.
But even that small advance could disappear, because that guaranteed benefits provision would be decimated by both the House and Senate versions of Trumpcare as they stand now – all in the name of “consumer choice,” of course. If certain members of Congress get their way, you’ll have the “choice” to buy a cheap plan filled with hidden gaps and time bombs that will give you little or no protection when you need it most.
The politicians spouting this nonsense know better. They realize the very idea of “free market health care” is a fraud. They just don’t want you to know it.
Bruce is Greenlining’s Media Relations Director. Follow Bruce Mirken on Twitter.