Express health clinics opening inside retailers such as Wal-mart have given people an alternative to expensive and time-consuming visits to a doctor’s office. So it was only a matter of time before the special-interest groups mobilized to do what they do best – use the government to hurt their competitors. Newsweek reports:
Critics complain that the clinics lead to “fragmentation” of care and incomplete medical records. Some doctors fear having to clean up messes left when clinics misdiagnose conditions (though so far no one can cite a single malpractice claim). Last month the American Medical Association called for an investigation into the clinics, based partly on the potential conflict of interest regarding drug sales.
The AMA is run by doctors. These clinics are stealing customers from doctors. Call me a cynic, but I don’t think the AMA is calling for an investigation of the clinics out of concern for patients.
By stealing customers from doctors due to lower prices and quicker service, the clinics are placing some much-needed market pressure on traditional health care services. The Cato Institute blog recently cited a New York Times article that describes the beneficial effects that have already resulted from the competition:
The [American Academy of Family Physicians] is spending $8 million on consultants who visit doctors nationwide to suggest improvements in patient care. The advice is meant to “keep them from going to an in-store clinic,” Ms. Denning said, while also benefiting doctors by making office procedures more efficient.
Sadly, the biggest threat to this newfound competition for routine health care may not be the AMA (or at least not the AMA alone). Advocates of universal health care coverage could do far more damage.
The reason health care costs keep rising is simple market forces. By and large, people pay for health care with ‘insurance’. This is not insurance in the normal sense of the word, like auto insurance or fire insurance. Normal insurance is used for catastrophic expenses. For instance, you use your auto insurance when you get into an accident. You don’t use it for oil changes, new tires, tune-ups, and car washes. If your auto insurance covered all that, you would of course always go for the highest-quality oil, the best tires, the deluxe car washes – whatever you could squeeze out of your insurance. Or maybe you’d just take whatever was recommended to you. What you wouldn’t do is shop around and compare to get the best deal - what’s the point when your insurance is paying for it all? This sort of payment arrangement increases demand and removes price competition. The result is increasing costs for routine auto care and auto insurance premiums. Now just add employer-funded auto insurance to this recipe so that you don’t directly see the rising cost of premiums, and you’ve created the perfect environment for runaway auto care costs.
Health care costs in this country are still affected by price competition by a couple of groups - people with high-deductible insurance such as HSA plans, and the uninsured. These are the people most likely to go to a low-cost clinic, and they are the big reason that these clinics have proven so popular. Universal coverage could do away with one or both of those groups (assuming the government could actually get everyone to sign up, which so far Massachusetts has failed to do under Romney’s universal coverage scheme).
As soon as universal coverage has cured the problem of the uninsured, it will also cure the problem of price competition. It’s not hard to imagine the result.
So count me a member of the Anti-Universal Coverage Club. Hopefully these clinics and other forms of real competition in the health care industry will be allowed to thrive and do what they do best – make goods and services more widely available for less money – despite the efforts of the AMA and the backers of universal coverage.
Should there be a standard baseline of healthcare expected for the uninsured?
If so, would that not be a form of Universal Coverage? Just not full blown liberal Universal Coverage.
We need to get away from a system where everyday health care is paid for through ‘insurance’. If we must subsidize health care for the poor, there are better ways to do it. Vouchers, tax deductions, tax credits, etc… the more control we leave in the hands of the consumer (and the greater the incentive to be aware of prices and comparison-shop) the better. Insurance that you don’t have the right to refuse is the worst possible option – especially at the federal level.
The great thing about federalism (power shared between the states and the federal government) is that we can experiment with different approaches and observe the results over time. Massachusetts can have RomneyCare, New York can have HillaryCare, etc. Let different states pass different laws and 5 or 10 years down the road we can see in reality what’s working best. It’s much easier to change poorly-designed programs at the state level than at the national level.
We must also get away from employer sponsored health insurance. (I say this as somebody who has worked with insurance, as a doctor’s wife, and as a libertarian.)
Your average 30 y/o Joe can get a BCBSTX policy for about $90 monthly (Ipay $130 as a 35 y/o smoker). It is still written off against income just like through a job except it is not tied to your job-you deduct when you file your taxes. That way, if you get sick, you are not tied like a slave to your job. You can change employer without worrying about coverage for past medical events.
The deductibles are not too crazy (mine is $1000), and you think before you go to the doc for a sniffle. The key is to obtain coverage when you are young and healthy. Of course, people must also stop looking at free healthcare as a “right.”
That’s an excellent point. People love the illusion of getting ‘free’ healthcare through their employer. Make no mistake – the cost of that insurance is just part of your pay that you never see. The more control we return to the health care consumer, the better.
I normally jump all over the internet because I have the tendancy to read often (which isn’t always a great idea because the majority of blogs just copy from each other) but I must say that yours contains some genuine substance! Thanks for stopping the trend of just being another copycat site!