The 3/20/2010 WSJ reprinted a 1996 article by Milton Friedman (Patron Saint of Free Markets)-A Way out of Soviet-style Medicine . He uses a chapter from Solhzhenitsyn's The Cancer Ward. to make a point. Friedman's point is that employer sponsored health coverage, Medicare, and Medicaid took away freedom of choice for doctors & patients and led to an increase in medical costs. Dr. Friedman prefers tax exemptions for all medical expenses for consumers (no more employer coverage) and a medical savings account for each person to pay for his/her own care.
An editorial referring to the1996 article states: "Stripped of its romantic illusions, ObamaCare is really about who commands the country's medical resources. It vastly accelerates the march toward a totally state-driven system, in contrast to reforms that would fix today's distorted status quo by putting consumers in control."
Dr. Friedman and the WSJ editorial overlook the fact that physicians are agents of their patients because of a doctor's medical training. Also, patients cannot (nor MDs) make medical purchasing decisions because they do know the cost of all the alternative inputs to treat a patient. A common operation in this country, a knee replacement, requires "hardware" to be installed to repair the knee joint. There are several companies that produce the part and the price varies. But that price is unknown to the doctor & patient-the same is true for every input into the delivery of medical care, including the cost of labor, loan servicing, facility maintenance/repair, payment for non-medical supplies.....etc. Also on this network, you point out the obesity is increasing the #1 factor in increase medical care costs.
1. How can consumer choice and controlling the price of healthcare inputs be accomplished in the a highly specialized/technical field like medicine.
2. How can you factor in the cost of obesity into the price of medical care inputs to control costs?