BigBallinStalin wrote:Of course because you'd get larger opportunity sets unconstrained by public policy. Within each opportunity set are services and commodities provided at a wider range of prices (thus qualities) and quantities.
This all sounds nice in theory, but consider what happens in practice. Health care can never be exchanged like other goods for several reasons.
1) People have limited information about medical practice and about how to treat a complicated illness
2) When you are ill, you do not have infinite time to make a decision about what doctor to visit and how to weigh their advice
3) The price of treatment is not immediately evident to the consumer, so the consumer tends to make more expensive choices than they normally would if they acted completely rationally
These all play into the following point:
In government's attempts to improve the healthcare market (e.g. by granting license-based monopolies per State for the medical practice), then it prevents lower quality doctors (e.g. medics) from offering services similar to today's doctor in their clinics and hospitals. This policy consequently diminishes people's opportunity sets. Also, this policy allows doctors to more efficiently control their own labor supply, so doctors per State effectively become cartels per State (increased prices, decreased quantity). Therefore, people become stuck with the higher quality, thus higher-priced doctors. In turn, government policy has denied peoples' opportunities by inadvertently denying their potential gains of trade.
The reason why the license-based monopoly is crucial is because we are not worried about lower quality doctors but doctors who actively seek to take advantage of their patients. Homeopathy is an excellent example of this. We see this consistently today -- board-certified doctors will tell you it's important to receive a vaccination for pertussis, but some others will not (cf. Jenny McCarthy). This results in you making decisions which are bad not only for your health, but for the health of others around you (due to the lack of herd immunity). And of course there's the economic impacts that are likely borne on others when you are forced to receive treatment later on for a serious ailment that could have been prevented. Being treated by a doctor is not like being sold a television -- you're most likely to know what's best for yourself when it comes to buying a television. The same is not true in the case of medical care, which makes the field ripe for misinformation. The monopoly on health care treatment is one of the best things about a modern health care system.
"Free markets" won't provide the answer for everything, but instead it's used as a model which can obviously point out the direction toward greater improvement: simply put, greater competition and freer prices lead to expanded opportunity sets, and this all requires less centralization of government (centralization here meaning, greater scope of Federal government over the decision-making capabilities of citizens within their respective States and municipalities).
The other issue with free markets is that they inevitably exclude those individuals who cannot pay for expensive treatments (i.e. the poor). If one agrees that these people should receive some level of treatment regardless of their ability to afford it, then one cannot defend the free market to begin with (since this necessarily will never reach the ability to treat everyone at a cost which they reasonably can afford).
In other words, if you increase competition (by tearing down clumsy barriers to trade), then you allow for wider ranges in quality (thus price) of insurance and medical care. Therefore, you'll have prices at which people of many different budgets can meet. You may not like the prospect that some people are unwilling to pay for the best doctors (e.g. they don't allocate 90% of their budget toward health care), thus they'll settle for some lower quality doctor, but at least in this system, they get a doctor at an affordable price without lowering the budgets of all others (taxpayers).
The problem with this response, then, is that it ignores people who are
really poor. We're not just talking about someone in the lower middle class who will have to choose a mediocre doctor to get treatment; we're talking about the people who can't afford any reasonable standard of medical care while simultaneously paying their other debts. You can't just sit in your middle class (relative) ivory tower and forget about the people for whom getting treatment for their illness, even from the worst doctor, would
force them to allocate 90% of their budget toward health care.
In conclusion, if one believes that access to health care should never be denied, then they should fully support more steps toward freer markets, thus stepping away from essentially the barbaric means of the state (theft, coercion, and the continual reinforcement of incompetence and corruption). Upon a closer examination of voluntary trade and free markets, it is obvious that there is in fact much meaning to the idea of voluntary exchange in the health care market.
And what I meant by
completely defending voluntary exchange is, you would also have to eradicate all laws requiring doctors to treat patients in emergency situations.
