In my column last week I suggested that one of the reasons Americans tolerate paying so much more for health care than citizens of any other country — and getting less to show for it — is our gullibility. We’ve been far too willing to believe the self-serving propaganda we’ve been fed for decades by health insurers and pharmaceutical companies and every other part of the medical-industrial complex, a term New England Journal of Medicine editor Arnold Relman coined 35 years ago to describe the uniquely American health care system.
One of the other reasons we tolerate unreasonably high health care costs is gullibility’s close and symbiotic relative: blind adherence to ideology. By this I mean the belief that the free market — the invisible hand Adam Smith wrote about more than two centuries ago and that many Americans hold as a nonnegotiable tenet of faith — can work as well in health care as it can in other sectors of the economy.
While the free market is alive and well in the world’s other developed countries, leaders in every one of them, including conservatives, decided years ago that health care is different, that letting the unfettered invisible hand work its magic in health care not only doesn’t create the unintended social benefits Smith wrote about, it all too often creates unintended, seemingly intractable, social problems.
In a commentary for The Catholic Spirit, Jason Adkins, executive director of the Minnesota Catholic Conference, wrote after the 2011 government shutdown in Minnesota that, “The inability (of state lawmakers) to compromise (on the budget)…was not based so much on stubbornness or sheer partisanship as it was on adherence to ideological principle.”
He went on to note that “an almost slavish adherence to ideology in politics can and does inflict harm to the very people public officials claim to serve.”
That certainly has been the case in health care. Adherence to ideology has made it impossible for Democrats and Republicans in Washington to even have a civil conversation about how to expand access to care and reduce costs.
Meanwhile, the price tags for drugs and a stay in an American hospital have become so astonishingly high they can take our breath away.