Still on this?
Maybe you simply don’t understand what a marketplace is because your own experience with healthcare is rooted in socialists systems that don’t want people to believe they have any control over their own lives.
Here’s the definition from the meriam webster dictionary:
MARKETPLACE
Main Entry: mar·ket·place
Pronunciation: \ˈmär-kət-ˌplās\
Function: noun
Date: 14th century
2: the world of trade or economic activity : the everyday world
I think what you’re TRYING to say is that some people, due to inadequate finances, are unable to participate in the marketplace of healthcare- but that doesn’t change the nature of the system as market. It simply means that not all people can participate in that market through their own efforts, and they need help from other people to either negotiate services on their behalf (I call this
charity on the consumer side) or provide services at below market prices (and this is
charity on the provider side).
In the marketplace of healthcare, healthcare providers are offering their set of goods and services in exchange for your goods or services- that is, you are trading them your money for their care. There may be intermediaries, such as insurance companies, who negotiate costs ahead of time, but in the end, one group is providing a service, the other group is paying for that service. That is a marketplace.
So I guess I’m just not able to understand your point of view about this whole “the healthcare is not a marketplace” nonsense.
Let me give you some examples:
*]I occasionally need to go see a dentist. I relocated to a new city several years ago, and needed to find a new one. I didn’t just knock on the door of the first dental office, though. I talked to friends about who they see, I call offices and ask about rates, hours, and services, I checked various websites to see if the dentists I was interested in had any marks on their public records…
*]When my wife became pregnant, she didn’t just pick the name of an OB at random out of the phonebook. She talked to friends and colleagues, called a couple offices with questions about their services and their approach to care. She made appointments with and met with 3 OB’s before deciding which one she wanted taking care of her while she was pregnant.
*]We did the same thing to find a pediatrician for my daughter when she was born. We talked to people, called offices, made appointments with a few, and chose the one we thought was best based on their rates, appointment availability, expertise, and other factors.
*]If any of these doctors fail to meet our needs at some point in the future, we will drop them and find a new doctor who is better suited for me, my wife, or my daugher.
*]On the other side of the medical marketplace, I can reference my two brothers who are both dentists, and work together in private practice. They advertise their business through the radio, television, billboards, fliers, and other mediums. They have discount plans, they offer coupons, they have partnerships with other professionals in the community to share referrals and cross markets.
*]I just had a minor surgery yesterday-it went just fine, thanks for asking. Before ever scheduling the procedure witht the surgeon I checked out the references on my anesthesiologists, I checked out the facility where I was going to be treated, and I called a couple of other facilities to compare rates, hours, policies, etc. I didn’t change any of these factors, but I would have if I was at all uncomfortable with any of them.
These are examples of how people operate as responsible consumers in the healthcare marketplace. It is simply what people do when they are being responsible about their care. I do the same thing when you go to buy a car, or a refridgerator, or shoes. If a healthcare provider is too expensive for my budget, is lacking in experience, has bad hours, or is hard to schedule appointments with, I move on to the next provider.
You will probably say that I am in a luxurious position that most people aren’t privy to. Or, you might say that if I was in an emergency that I wouldn’t pick and choose who is providing care to me.
OK, let’s take the first one- I am participating in that portion of the marketplace permitted by my insurance provider. I am limited to medical providers by my private insurance provider. But within that network, I can choose whatever doctor I want, and I do. That is an option available to anyone with private insurance-they may lock you into your choice of primary care provider once you make it, but you can still choose that doctor based on your own criteria- and if you don’t like them, you can drop them at your next enrollment period. Specialists are even more subject to this marketplace environment, as you can pick and drop them any time you want.
As to your second likely objection, you would be right that I may not be able to choose my on call doctor if I went to the hospital at 3am on a weekend. But I would be able to choose my hospital, and once the emergency was over I would certainly shop the market for the best specialist to meet my needs.