In a categorically incorrect fashion, those market forces, whose intention it is to maintain the status quo of the U.S. health delivery model, stress the features and benefits commonly experienced in unrelated or hypothetical unregulated, competitive markets. The non-existence of a privatized health delivery market in any other first world nation to which we might compare our own, makes it too easy to erroneously accept the assumption that the essential market fundamentals of our model are healthy and functioning. Some will undoubtedly argue that in comparison to markets in which health services are rendered as a public good, any market that can render its product privately will be infinitely better off by avoiding the inherent costs of inefficiencies and other deficits that commonly plague markets of public goods. (Getzen 2007) However, the U.S. health delivery market is deceivingly non-competitive and imperfect in nature, and the related market costs of monopoly power can be eerily similar and equally devastating to the feared costs that exist in markets for public goods.

If the role of government is indeed to provide and maintain law, order, and justice, all of which subsequently lubricate the efficient operation of economic markets to function as perfectly as possible, there are several instances of over/under regulation which have undermined that very goal. (Getzen 2007) The transformation towards managed care companies acting as an intermediary payer, adjudicating transactions between buyers and sellers in theory could have provided private oversight and regulation more efficiently than the government. (Getzen 2007) The government’s failure to clearly define acceptable practices and business models for these firms has led to actuarial practices and cost sharing programs that focus solely on maximizing profits at the expense of providing wellness. (Stone 2008) Furthermore, at least part of the rising demand and resulting price of health services is directly related to the proliferation of managed care and other insurance.(Getzen 2007) The government has failed to insure that the prohibitive costs associated with actuarial practices that create an artificially high, non existent, speculative demand be equally distributed amongst the wealthy and poor, healthy and sick. Instead cost sharing programs such as raising premiums, deductibles, and copayments shift these costs to the sick and act as barriers to care for the un/underinsured. (Stone 2008) It hardly seems just to allow the parties whom medical services are directly meant to benefit to be gorged for what might be construed as cleverly disguised monopoly rents for obtaining them. Perhaps the morally sound philosophy should be that in the same sense that unlimited access to the best medical services and cutting edge technologies could never practically be considered an inalienable right, affordable access to basic care should never be considered a privilege.

Getzen, T. (2007). Health economics and financing (3rd ed.) Hoboken, NJ: Wiley.

Stone, Deborah. Protect the Sick: Health Insurance Reform in One Easy Lesson. Journal of Law, Medicine & Ethics. Winter 2008, 652

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