The Dying Game

Can a merciless marketplace be entrusted with caring for people?

Some things should not be left to the open market to decide, like healthcare for all. The market is an indifferent player in the realm of human beings, living creatures with emotions and vested interests that come into play on individual and communal scales. Some economists (F.A. Hayek comes to mind) and commentators have placed their trust in the inherent ‘wisdom’ of the marketplace, which they believe can correct all wrongs, if only given the chance. While this may be true, depending on the prism you happen to be viewing the market through, the free market economy is by no means benevolent in its judgments. Sometimes, when it comes to efficiency and generating profit, it’s better for a particular industry (35mm film shops, newspaper classified ads, video stores), or an entire sector to die.

Some services simply shouldn’t be based upon a strict adherence to a model based upon maximizing profits.

Economics and market activity, in many ways, can be looked upon as a simple, or complex game. Winners and losers alike try to create a successful business, and fight off competitors, given the rules and economic theories surrounding the game. While some players may cheat, others rely upon automation, efficiency, sound business practices, a superior product, cheap labor, offshoring, innovative ideas and a host of other tools to ‘win’ the game. Substantial competition in a more or less fair marketplace makes for a competitive and robust economy. That having been said, some services simply shouldn’t be based upon a strict adherence to a model based upon maximizing profits.

When your house is on fire, and every house in your neighbor is burning as well, would it be appropriate for the firemen on the scene to ask you how much you’d be willing to pay for them to douse the blaze? Imagine if they only rendered services to the highest bidder, and let everyone else’s property and families go up in flames. After the floodwaters have come, should rescue workers check on your ability to pay for help before pulling you off your roof? What if they declined to lend you a hand because you had a small child with expensive medical requirements, and by their calculations, it would be far more profitable to dump you and help someone else instead? In times of crisis, the needs of the community should trump profit-based incentives. Of course firemen, rescue workers and police officers should make reasonable salaries (everyone needs a motivation to work), but their specific services should not be dictated by the open market.

This brings me to the never-ending healthcare debate that has plagued the United States for so long. Should taking care of the sick and providing preventative medicine be a community right, like the police protection we all enjoy, a personal responsibility, or a privilege that comes in the form of company benefits? If the market were to solely dictate the bottom line, then it would clearly be more profitable to let certain people die, like the uninsured who show up at hospital trauma units with life threatening injuries, or the children of the poor with conditions and diseases that take a lot of money to treat and cure.

A healthy country makes for a better country. Access to decent healthcare is a pivotal part of that equation. When people no longer have to worry about expensive medical bills, or can unlock the handcuffs that have held them to bad jobs because they were afraid of losing their benefits, they’re freer to pursue better career options, retrain if their particular industry becomes obsolete, and continue to contribute to an evolving society.

Is universal healthcare costly and open to abuse? Absolutely, just like many other public services we take for granted, but it beats letting people riddled with disease and debt fall by the wayside. Our health and the health of our neighbors affect everything we do, as well as the things we leave undone. Hospital bills don’t usually disappear after someone has departed this earth.

I’ve lived in several different countries in my life. All of them have had a national healthcare service of one kind or another. Sometimes people ask me about the costs of those systems, or the long lines and waiting times people have to endure in order to see a doctor. While I’m no expert on the matter, I have to admit that yes, some of those services take a hefty bite out of the fiscal budget, and people with moderate complaints (emergency services are still treated like emergencies) often have wait to see a doctor. I have yet to come upon the perfect system, but still, everyone is offered access to treatment in the end, despite the bureaucracy and the wait, which is a hell of a lot better than dealing with a lingering illness, or dying from medical neglect.

Most, if not all, of these countries also have private hospitals and private insurance. That’s a fact that many pundits who are against state run healthcare often skip over. If you want to pay and avoid the hassles of the public system, you can, but due to the competition coming from the public sector, you probably won’t have to pay the premium rates so common in the United States. You could compare these two options to the military and war. A general can make use of an army comprised of professional soldiers paid for and recruited by the state, or else employ of a bunch of highly paid mercenaries to achieve his objectives. Both groups might get the job done, but they would manage risk and operate in very different ways.

We shell out tax dollars and pay people to fight crime, fires, natural disasters and foreign wars, thus keeping us safe from harm. Doesn’t it make sense, no matter how flawed the system might be (although we should always strive to make it better), that as a society we should set some funds aside for healthcare and protect our investments in human capital, which is vital to the health and the future of the country?


Read more of Carl Pettit’s weekly column, Root Down, on The Good Life.

Image credit: jencu/Flickr

About Carl Pettit

Carl Pettit is a writer, illustrator and musician whose education and travels have taken him all over the world. When not out exploring, or pondering the universe, he finds time to produce fiction for both adults and children. You can catch up with him on his blog, or twitter.


  1. Richard Aubrey says:

    Just for grins, check out UK NHS pap smear. See their suggested first time and intervals and compare it to ours.
    You’ll note some suggestions that mammograms aren’t necessary as often as we thought, and ditto PSA. This is known, in military parlance, as “preparing the battle space”. Tests cost money. Of course, they mean some things aren’t caught until too late, but see the treatment max for whatever that may be. Savings all around.

  2. Richard Aubrey says:

    KKZ. New technologies aren’t invariably more expensive. What you mean is that, if we use a new technology instead of letting somebody die, the cumulative costs are higher. True. In addition, new technologies can be cheaper than old ones for a given issue. See any railroad tracks on knees these days?
    Keep in mind that a profit-driven enterprise can’t work unless it pleases the customer, either the current ones or the prospective ones. See Adam Smith.
    Government is immune from such mundane considerations. I know, there are elections, but as a friend of mine who works for the state said, the legislators come and go and we just keep doing what we do.

  3. I’ve been entertaining this notion a lot lately too – that hospitals shouldn’t be run as businesses, and that the universal healthcare systems in places like the UK may not be perfect, but are still better for the greater good of the populace than strictly private systems. And THANK YOU for pointing out that a public healthcare system does not mean the elimination of private options too. If anything, I’d think it would force the private sector to make the necessary changes to be able to compete with the public system.

    (That said, I’ll note that I have a very limited understanding of economics in general, never mind the economics of healthcare, so I’m no expert. These are just my casual musings from the morning commute.)

    Maybe I’m just cynical but I don’t trust the private sector to look out for anyone’s needs but their own. Profit may be a great motivator for innovation, as Rob points out above, but it also prompts people to make not-so-nice decisions if there’s nothing to gain. A profit-based model is pretty much built to be self-serving, not others-helping. Frankly, if I had to choose, I’d rather see an increase in access to healthcare for people who need it while innovation slows a bit. After all, innovation creates new technologies, and those technologies are inevitably expensive, so creating innovations in the name of profit still isn’t helping the Little Guy that much.

  4. Richard Aubrey says:

    I understand a medical device company has laid off, iirc, 1100 workers due to assuming reduced sales on account of the new and exciting medical device tax.
    This will also reduce research on new devices.
    Somehow, somebody thought this was a good idea.
    I don’t know about the market and ruthlessness. One of the advertising department’s woes is lousy performance. Hard to get past that, once it gets public. OTOH, a governmnent bureaucrat trying to impress his bosses with cost savings is immune from any negative feedback. Where else are they going to go? Shrug. Lots of great stories from the UK.

  5. Blindness! Profit has driven every innovation in medicine was have!!!
    Profit and Healing are co-hostiles. They are the epitome of team-work!

    I guarantee you this: Injure the profit and you’ll STOP the innovation dead in its tracks!

    Stop the profit, and you’ll shutter countless hospitals.

    Without the motivations of profit you’d not have that keyboard in front of you.

    • ***Profit and Healing are NOT co-hostiles.***
      ***Profit has driven every innovation in medicine WE have!!!***

      Sorry…blind with migraine

    • Here’s the thing: Technology (keyboards) is a luxury. Healthcare shouldn’t be.

      Besides, innovation isn’t necessarily profitable. In healthcare, one can assume that the goal of innovation is to cure the disease. But it’s not really profitable to cure a disease, now, is it? It effectively cuts off a whole revenue stream – the money paid by people to treat the disease (short of a cure). Not just on doctor’s visits, but pharmaceuticals too.

      Cynical Me says that healthcare & pharma companies are innovating all right – they’re innovating new ways to make money off the sick – not to free them of their afflictions, or make care more accessible.

    • I have very mixed feelings on this post. A few points:

      – Even pre-Obamacare, it was illegal for emergency rooms in the U.S. to turn away people in need of life-saving medical treatment.
      – Profit does not drive all medical innovation. Jonas Salk refused to patent the polio vaccine because he wanted to help people. He said it would be like trying to patent the sun.
      – I voted for Obama twice, but I also find it ironic that the U.S. is getting relatively universal health care – what we’ve always been told is the chief way we’re lagging behind the rest of the industrialized world – right when much of the rest of the industrialized world is starting to get crushed by mountains of public-sector debt.
      – Obamacare also sometimes seems like a trick to get healthy younger uninsured people into the risk pool and drive costs down so we can keep giving seniors 50 kajillion pills a dau.
      – I still give Obama credit for working on reform. The U.S. healthcare system seems almost tailor-made to ensure ballooning costs, particularly due to unnecessary tests and marginally-useful procedures being covered by insurance.

      I don’t have all the answers on this. Anyone who says they do is suspect. Human needs are relatively finite. Human want is limitless. A lot of medical care in the U.S. falls somewhere between the two.

Speak Your Mind