Health care and the free market

I love my DVR. I can watch what I want when I want and I can pause a show and YELL AT THE TV! I did that the other day watching Kentucky Republican Sen. Rand Paul’s appearance on The Daily Show. Early on in the interview, he pulls out the patently false argument that competition will bring down health care costs. He’s an eye surgeon, and notes that prices for Lasik and contacts have dropped thanks to competition. That’s when I had to pause and yell, “THOSE ARE ELECTIVES!” Lasik and contacts are alternatives to glasses, which already work perfectly well to correct vision problems. If you don’t want to wear glasses, fine. You pay the extra cost for your contacts or surgery.

Here’s why Paul is wrong. If you’re having chest pains, do you run to the computer and Google “cheapest bypass surgery?” Of course not. On top of that, if you have insurance, your choices are restricted to hospitals that have contracts with your insurance company. (If you don’t have insurance, you’ll probably end up bankrupt.) And, do you really want the cheapest bypass surgery?

Competition and the free market work great when consumers are well-informed and have a number of choices. Cars are a good example. We see tons of ads. We hear about crash tests and mileage. We can check prices on line. You can haggle, playing one dealer off another. When you take into account inflation and how advanced today’s cars are, they’ve probably never been cheaper. Hooray for competition and the free market!

But health care isn’t a Ford F-150. Not buying an F-150 won’t kill you. We don’t have a lot of choices in health care, and we know a heck of a lot more about cars than we do health care. Carnegie Mellon University recently gave about 200 people who had employer sponsored health insurance a multiple choice quiz asking them to pick the correct definition for four basic health care terms: deductible, co-pay, co-insurance and out-of-pocket maximum. Only 14 percent got all four right! (I wonder how those people would have done if it had been a quiz about bypass surgery.)

So what are Paul and the rest of the free market health care brigade up to? I honestly don’t know. I guess they’re either blinded by their allegiance to free markets, or they’re in the pocket of the health care industry. Either way, they’re wrong, and they’re doing their constituents and the country a disservice by not working to find practical, workable solutions to start bending the curve of the cost of health care in the right direction. 40 votes in the House to get rid of Obamacare aren’t part of the solution.