Republican Health Care Follies

I wouldn’t have said it as bluntly myself as I have a definite bias here, but Mike the Mad Biologist explains How to Build a Healthcare System That Kills People. He begins by posting the response by Atrios to the Republican idea of “a radically different kind of medical marketplace, in which families armed with specific information about the treatment success and prices of hospitals and doctors can shop at will for the best quality and most affordable care.” Atrios wrote, “We pay doctors to make these decisions for us because most of us haven’t been to medical school. I know this point is simple and obvious and everyone makes it, but as I said before our elite discourse is so fucking stupid.”

Mike discussed this point further, writing:

One of the most ridiculous ideas to come down the pike is the notion that most people, who are woefully ignorant of medicine and biology (e.g., the massive misunderstandings a out antibiotics and infectious disease), will actually make intelligent decisions regarding their own healthcare. In fact, I bet most people would do worse than flipping a coin in many situations. That’s before you get to the roughly twenty percent who are functionally illiterate.

This probably sounds elitist. And you’re right, it is elitist. Because, as Atrios notes, medical doctors are part of an elite group of people who have extensive experience and training in medicine, which most people lack. While trying to ‘puzzle out’ your healthcare treatment options isn’t quite as stupid as trying to puzzle out how to build a nuclear reactor, it’s still pretty stupid.

Besides assuming that the average person is able to accurately interpret data on cost and quality of care, this assumes that there are sources which can offer health care at a lower rate than which is now charged. On the one hand Republicans claim that any government intervention which might reduce income to the health care industry will destroy our high quality health care system. On the other hand, they claim that the free market will magically allow doctors, hospitals, and pharmaceutical companies to charge significantly lower costs without impacting quality. The savings that Republican ideas might bring about would be trivial for those who are uninsured or under-insured.

I’ve also seen discussion at several conservative and libertarian sites where they believe that patients will be able to make medical decisions, often saving the cost of paying physicians, by doing their own medical research on the internet. The internet is often a valuable source of information, but this will never replace the expertise of doctors. There is a tremendous amount of misinformation on line. Even when the information is accurate, patients without the medical background to adequately understand the data often come to quite erroneous conclusions based upon what they read on line.

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