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June 14, 2010
Bartering for healthcare isn't as crazy as it sounds
Political opportunism reigns during election years. A candidate need make only one misstep, one errant statement, for an opponent to move in for the kill. Sometimes the blunder is real. Other times it's a matter of spin and perception. Nevada's ex-Senate candidate Sue Lowden, a Republican, learned this lesson firsthand.
Lowden became a target when she suggested that patients should barter for medical treatment. The fur really flew when she spoke of how our grandparents bartered chickens for their doctor's services. Democrats seized on Lowden's apparent silliness. They launched a "chickens for checkups" website and attended Lowden's campaign events dressed in chicken suits.
Lowden's detractors never considered her accuracy. Bartering was routine in bygone days. People traded their goods and services for needed goods and services, including medical attention. However, at face value it's hard to imagine a barter system working in the contemporary healthcare market. Today's physician couldn't pay for student loans and malpractice insurance with roasting hens and bushels of corn. But what if we look beyond the surface of Lowden's statement?
Thoroughly examining the situation--a rarity in contemporary political discourse--reveals that Sue Lowden's bartering proposal wasn't as foolish as grandstanding Democrat's claimed. In fact, Lowden has touched upon a workable solution to soaring medical expenses.
Bartering is based on the principles of the free market. It is the voluntary exchange of a good or service that ultimately satisfies all involved parties. This is a common occurrence in all walks of life. For example, suppose a baseball team needs a left-handed pitcher in their bullpen. The team will trade unneeded players to a willing team for the needed pitcher. Both teams have actively participated in the voluntary exchange of held value in one area for needed value in another.
Trading a chicken for a dose of penicillin may not lower healthcare costs per se. But the free market principles that bartering represents will reduce healthcare costs significantly. Sadly, these standards have disappeared from the medical profession.
Few people know the cost of the medical treatment they consume; it has become an afterthought. We are conditioned to surrender our co-pay or file our claim and go about our business. With the consumer removed from the equation, there is no downward pressure on price.
What would happen if patients considered themselves as healthcare customers and doctors as distributors? Such a customer/provider relationship works to control prices in a host of other industries where transactions are subject to comparison shopping. Consumers naturally seek the greatest value, defined as the most return obtainable at the lowest practical cost. This process will establish median prices for various medical procedures, too.
Currently, there is no direct consumer pressure on healthcare prices. To assume a government run system will improve that situation is to believe in the tooth fairy. In fact, ample evidence has long existed to think that government involvement will only worsen the condition.
Medicare, Medicaid, the Veteran's Administration and SCHIP are expansive, expensive, and unresponsive bureaucracies, rife with fraud and inefficiency. Another bureaucracy that further removes the patient from the direct cost of basic medical care won't control costs. It will only mean less return for each expended healthcare dollar.
The quaint notion of swapping chickens for medical attention rings of nostalgia if not reality. But the basics behind old-fashioned bartering are real. Bartering represents direct involvement between market participants, in this case patients and healthcare providers. The subsequent competition between medical professionals for the patient's business will reduce healthcare costs while ensuring that treatment remains readily available.
On our present course we can expect an exponential escalation in healthcare costs, and we'll get less bang for each buck.
Anthony W. Hager has authored more than 200 published articles for various newspapers, periodicals and websites. He can be reached through his website, www.therightslant.com.