Dr. Ben Carson, a retired neurosurgeon and conservative sensation, is taking a couple of major steps toward a 2016 presidential bid, forming a political action committee and selecting a campaign chairman for a potential White House run, FoxNews.com and others are reporting.
A lot of people assume that because Dr. Carson is an outspoken opponent of Obamacare, he is therefore an advocate of a free market in medicine (or at least a freer one than we have.) But the first does not necessarily imply the second. For evidence, consider his comments on the subject of health care.
It is true that Dr. Carson called Obamacare the “worst thing since slavery.” But the real question is: What would he replace it with? A free market? Privatization and phasing out of all government intervention in health care – including ultimately Medicare, which cannot sustain itself indefinitely?
Not at all. In fact, shockingly, Dr. Carson’s solutions to health care differ little in principle—or in content—from Barack Obama’s. They’re possibly even worse.
In his book, America the Beautiful, Carson writes:
Today, insurance companies call the shots on what they want to pay, to whom, and when. Consequently, even busy doctors operate with a very slim profit of margin.
This is an ideal place for the intervention of government regulators who, with the help of medical professionals, could establish fair and consistent remuneration. To accomplish this, essentially all of the insurance companies would have to become non-profit service organizations with standardized, regulated profit margins.
This is not the paradigm that I see for all businesses, [but] is uniquely appropriate for the health-insurance industry, which deals with people’s lives and quality of existence. That may sound radical, but is it as radical as allowing a company to increase its profits by denying care to sick individuals? In the long run this would also be good for the insurance companies, who could then concentrate on providing good service, rather than focusing on undercutting their competitors and increasing their profit margin.
As a conservative Republican Dr. Carson is, he says, in favor of a free market—except when it comes to doctors, nurses and hospitals. He’s no different from the Obama types when he implies, “Profit and private ownership may be good for other things—but not for medical care. Medical care is more important. Therefore, we’ve got to remove profit from the equation.”
But if medical care is more important, shouldn’t it be subject to private ownership and profit incentives every bit as much as anything else? Obama types don’t like the free market elsewhere; at least in this respect, they’re more consistent than Ben Carson.
Economically, Dr. Carson’s error is he focuses on insurance companies as inevitable outgrowths and byproducts of a free market. Health insurance companies are awful, he concludes; therefore they must be regulated, to the point of turning them into the equivalent of public utilities (which Obamacare, by the way, is already attempting.)
But modern medicine has never operated under the conditions of a free market. In a totally free marketplace for medicine, doctors and patients would be dealing and trading with each other directly. Pricing would be set by supply and demand, and all the other factors operative in a free market.
As prices for medical care and technology went up, suppliers – profit-making doctors/hospitals and profit-making producers of medical technology – would flood the market with products and services, thereby bringing the cost down. Profit is the lifeblood (economically, morally, psychologically) of supply; and without supply, there is nothing of value to socialize or nationalize, even if that’s your goal.
Health insurance companies, while they certainly would be free to exist for a profit in a free market, would not be the only defining factor. Dr. Carson assumes that they would be, but that’s only because in the “mixed economy” of medicine as we know it, government has sought to foster health insurance by providing tax credits to employers for providing health insurance. For all of our lives, the federal government has incentivized—almost mandated—the average employee to be covered by health insurance. This government intervention led to insurance companies playing the role in medical care that they did. It’s a much bigger role than they ever would have played in a free market with no government incentives, mandates or regulations. Obamacare strengthens the power of health insurance companies by literally forcing people to buy health insurance (or depend on the government for coverage.)
Like most physicians, Dr. Carson doesn’t like insurance companies. But he appears to assume they’re in the nature of a free market, and the only solution is for government to regulate them—in a sense, take them over by turning them into quasi-government monopolies which don’t have to concentrate on competing. How will this help doctors and patients? Instead of having to deal with for-profit insurance companies who could potentially go out of business (or decline in stock value), and have to provide some measure of customer (beneficiary and provider) satisfaction, doctors and patients will have to answer to one or two government-protected monoliths. That’s exactly where Obamacare is pushing us now.
It’s clear that Dr. Carson isn’t in favor of freedom in medicine. He’s merely against insurance companies. He’s right to be against insurance companies as we know them, as they are the profit-making semi-fascist perversions of a mixed (socialist/private) economy in medicine. But he’s wrong to accept the assumptions of that mixed economy as inevitable, and simply regulate the insurance companies out of making a profit. As I said, we’ve already got Obamacare.
Dr. Carson has written extensively about his fundamentalist Christian faith. Christian faith (like secular leftism) emphasizes the viewpoint that we are all our brother’s keepers, and we must approach life with a selfless duty of service towards others. This undoubtedly explains much of his antipathy towards profit in the field of medicine. This is the thinking that has to be challenged if medical care is ever to get out of its perpetual crisis.
Human beings are actually at their best when they stand to make a profit. Profit means a lot of different things. It definitely means money-making, but it also means achievement, purposeful success and even beating out one’s competitors, at times.
Profit allows for the self-responsibility and personal pride in what one does, whether one is an insurance company, a hospital, a doctor, a nurse or anything else. Dr. Carson, like so many conservatives, finds it hard to reconcile the virtues of profit-making with what he sees as the virtues of selfless unconcern with anything personal that’s supposed to be characteristic of doctors and nurses, but not anybody in any other profession.
It’s a deadly view, with literally life-or-death consequences when it comes to medicine.
It saddens me to break the news that Dr. Ben Carson’s candidacy, and presidency (if it happens) will not be anything close to a solution. He deserves credit for courageously standing up to the arrogance and “cool factor” of the Obama phenomenon, at its peak. But it doesn’t make him right—not even close.
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