FRAMESHOP:FRAMESHOP: 'USED CAR' HEALTHCARE

Yesterday in Minneapolis, President Bush talked about what he called 'healthcare transparency,' an example of Orwellian doublespeak if ever there was one.

This is the main point that President Bush raised:

I don't know how many of you all have ever said, gosh, I wonder how much this procedure is going to cost me, or before I go to see this person, I want to know how much it costs, or maybe I need to know what this hospital charges. I doubt many of you have done that. I think the new trend in medicine is going to be to encourage transparency in pricing, as well as transparency in quality. And that's the subject of today's discussion. How do we encourage consumerism. What do you do? Well, one thing you do is you make sure people understand their options, how much something costs. And if they decide to make a purchase, what do they expect, what are the expectations from the consumer?

Keep this statement in line the next time you are lying on the ground with chest pains or have just broken your arm, or have just suffered multiple head trauma from a head-on car collision. In these moments, how happy would we be if we had to sit back and ask, "Gosh...I wonder how much it costs to have quadruple bypass surgery? Can I get a better deal if I go to County Hospital instead of St. Judes? I wonder if they have a price list on their websi--" And of course, the sentence ends because...you've died!

But despite the obvious comedic quality of his proposal, President Bush keeps on pushing a 'Used Car' approach to healthcare.

The Logic of 'Used Car' Healthcare
President Bush's 'Used Car' approach to healthcare begins by changing the word Americans use to talk about the sick from 'people' or 'patient' to 'consumer.' When most people get sick they think of themselves as 'patients' in search of a 'cure.' In the 'Shop 'n Save' scenario, a sick person becomes a 'consumer' insearch of a 'good deal.'

In President Bush's vision of the healthcare future:

Doctors would start acting more like used car salesman. (e.g., "What's it going to take to put you in a new hip, today?!?!)

When we walk into a doctor's office, today, we expect a doctor to say,"Tell me how you feel" or "Tell me where it hurts."

In President Bush's 'Used Car' world of healthcare, the doctor would walk into the examining room and say,"Have I got a deal for you!" or "On special for a limited time: arterial stints, buy-one-get-one-free."

Hospitals would suddently have "Early Bird" specials.

Pharmaceutical companies would launch soda-cap style prize contests (e.g., "Behind ever Procrit label is a chance for you to win a luxury trip to Las Vegas!!")

Rehabilitation clinics would start 'frequent flier' programs.

Orthodontists would give 'trade-up' incentive plans and second-hand discounts (e.g., "Want new veneers but don't have the cash? Trade in those old dental retainers for cash, today!")

Pharmacies would develop wharehouse stores that gave out samples like Costco (e.g. "Today we're offereing samples of the new Lamasil cream? Have you tried it, yet? It works great!")

Surgeons would develop a whole new line of do-it-yourself-and-save stores.

Psychiatrists would launch fast-pitch TV commercials: "Trade 'n Save psychiatry clinics! Feeling depressed? Worry too much? Hearing voices? Call in the next hour and your first month of group therapy is on us! We guarantee you'll feel better or we'll give you your money back. With prices this low, we must be crazy!"

We Are People, Not Consumers
Of course, the logic of 'Used Car' healthcare is that health is a market and by fixing the market we fix people's health. Wealthy is healthy.

It just does not work that way.

Good health is not the product of competitive markets. It is the product of care for people.

Care. For. People.

And the way for Progressives to frame the healthcare debate is to state the principle that we all believe:

Good health begins with a commitment to treat all Americans as people

What a basic and obvious point! But we need to say it.

Next, we need to identify the threat against good health, which is the endless pressure in the healthcare industrty to see all people as opportunities for profit:

So long as big corporations are encouraged to see each American as an opportunity for profit, the health of the American people is in danger.

Good money for good health--that is the logic of the healthcare industry.

And that is a logic that endangers the life of every American--young or old, rich or poor, healthy or sick.

What logic should replace it? Healthy people, strong America.

The more we dodge the basic reality that people must be healthy for the country to be strong--the more we cash in on America's future for short term profit.

Why Now? Why Bush?
My guess is that President Bush and the Republican party believe that of all their dire polling numbers, the public still wants to talk about healthcare solutions. So they are returning to the initiatives they put on the back burner years ago--health savings plans.

It will not work. Americans do not want 'Used Car' healthcare and all it will bring.

Americans believe that health is about people, and that healthy people make a strong America.

© 2006 Jeffrey Feldman, Frameshop