Why competition in health care sucks

--and why it should be a public good.

http://www.thelundreport.org/resource/is_competition_really_good_for_healthcare

The bronze and silver policies that most people will select under Obamacare have enormous deductibles so that people are discouraged from seeking routine medical care and from getting the companies to provide something in return for the premiums. And the companies will continue their efforts to avoid caring for the sickest patients and to deny coverage whenever possible. The “choice” in the “healthcare marketplace” is limited to policies of companies whose bottom line is not patient care, but profit. (The “not for profit” companies have the same bottom line as those that are “for profit”--they just have to call it something else.)

Is competition among drug companies a good thing? One would think that “ethical pharmaceuticals” would compete to offer the best products at the lowest prices. But like the health insurance business, the “competition” is only to see who can derive the maximum profit. We get the drugs that are most profitable and most easily marketed, not the drugs we need. And the price of the drugs is whatever the drug companies can get away with.

The business model of competition and profit seeking is even being foisted on doctors. “Pay for performance” is promoted as a way to get doctors to improve the care they provide. What an insult to the medical profession! Doctors don’t need a financial incentive to be motivated to provide quality care for their patients. When pay for performance has been put into effect, doctors and hospitals have shown that they know how to game the system, but there has been no evidence that pay for performance has actually improved patient outcomes.

If competition is so wonderful, why don’t we have competing police departments, fire departments and armed services? Clearly, the business model--competition and making a profit--is not always appropriate. The competitive model for healthcare is a terrible idea--inefficient, immoral, and colossally expensive. A recent study estimated that a single payer system would save $592 billion in administrative and pharmaceutical costs. Will we ever get a system whose bottom line is not making money, but caring for patients?