A Healthy Market
Wheaton College Philosophy Professor Stephen Mathis questions “how appropriate it is to address health concerns using a for-profit model”:
Consider that we have numerous treatments for erectile dysfunction, while drug companies have resisted putting resources into finding a cure for malaria, a disease most prevalent in poorer countries.
Professor Mathis might profit from a viewing of my video blog describing the effects of attempts at manipulating economic behavior. We have treatments for erectile dysfunction because people want them. Reformulating the healthcare system in such a way as to deny that sort of research and to force investment in other areas of less market demand will not have the intended effect and will require escalating infringements on freedom.
For the individual, the choice isn’t between cures for erectile dysfunction and malaria research, but between cures for erectile dysfunction and a new car (or whatever else the individual might spend his money on). Push hard enough, and the choice becomes one between funding malaria research and declining to work so hard or take financial risks with the hope of prospering.
Mathis has other misconceptions about medicine and the market:
First, we tend to think it inappropriate to profit from others’ misfortunes, whether they are illnesses or accidents. This also helps explain why our police and fire departments are all either government-funded or volunteer. So when it comes to protecting lives or saving them, we disapprove of those who profit from others’ misfortunes because they take advantage of others when they are vulnerable.
Second, we have laws against buying and selling human organs. We do not let individuals buy or sell organs because we think it is inappropriate to put a price tag on such things as bodily organs. This also explains why we do let individuals donate organs.
In the first case, I’d suggest that it isn’t an abstract sense of appropriateness at play, but of danger. Nobody begrudges financial gain for those who save lives; rather, we’re wary of circumstances in which lifesavers could leverage dire need at a crucial moment in order to extort greater payment. It’s not that we have a moral problem with police and firefighters making a healthy living for their services and the risks that they take; it’s that we fear a scenario in which they stand at the door with their hands out before collaring the murderer or dousing the flames. The former is a matter of compensation; the latter is a matter of complicity in crime and destruction.
Similarly, in the second case, we don’t fear that devaluing organs through sale will devalue their owners. The devaluation of the person comes first. If you’re a person with explicit dominion over your body, then others must approach you as a being capable of making decisions, a peer; if you’re a shell for valuable organs, then others can focus on plying those organs from you. Consider:
… outlawing organ sales is a way of making clear that, as a society, we think individuals should never have to face certain decisions — say, between filing for bankruptcy or selling a kidney.
Wrong. Outlawing organ sales is a way of preventing immoral actors from targeting your finances as a means of acquiring your kidney. Indeed, it cannot be moral, and it devalues organs, to declare that a man must watch his family suffer because we’ve erased his kidney’s market value. Not allowing individuals to “face certain decisions” doesn’t relieve them of the horror of their circumstances. In that case, organs are literally worthless, except insofar as they keep individuals sufficiently healthy to make of themselves workhorses. But it devalues the entire person — and his family, too — if constructing an economy full of pitfalls can push him toward harvesting his body. In other words, it isn’t the decisions of the individual against which we’re guarding, but the decisions of the entire society.
The implications for our healthcare system are straightforward. My premise is that we restrict acute freedoms (such as selling one’s organs) and circumscribe the profitability of safety in order to protect the vulnerable from the powerful. Consolidating healthcare decisions and handing the powerful a right to make them hardly alleviates that danger.