A gentleman who wrote a Letter to the Editor at The American Prospect raised a very interesting point concerning the bogus claim that, in his example but the lesson works in an infinite array of economic instances, that in regards to the health care industry the so-called competition in the marketplace is a lie. In fact, the belief that there is any true competition is so wrong that the very foundation of capitalism is completely missing from the economic model we see today.
This fellow, one Fredrick C. Sage, posits that there are five conditions that must be met before competition in any industry can be termed effective.
First, the consumer must be able to identify their wants and needs. This needs little explanation.
Second, the consumer must be offered services or products of varying quality and price.
Third, the consumer must be able to judge the differences in quality between the various products or services.
Fourth, the consumer must have a certain high level of bargaining power.
Fifth, the consumer must be free to purchase or to not purchase the product.
Looking at how these conditions relate to the health care industry in particular, we see that none of them are met or are met on the most limited basis.
What does the consumer want in the way of a health care plan that fits their particular needs? How can a consumer become informed of the prices and services offered and how does he research the quality that these products offer? If you've seen the ads for various health plans, you will have noted that they are all feel good pictures of a mother and her new born infant or a happy, smiling family or any of the various generalities that passes for information regarding health plans. No where is there information concerning costs or limits on services or choice nor is there any real way to discern the differences in quality between them since any reliable data concerning the level or care of the satisfaction of the members is simply never discussed. One cannot determine the number of members who are refused life-saving procedures due to cost restrictions. One seldom hears about the doctors enrolled in the plan and whether their actual training and experience is near or above the national average. Basically, unless you are a truly informed consumer with loads of spare time to delve into the often arcane language used in the policies offered, there isn't any way whatsoever to determine the many differences between the generic offerings from the HMO industry.
As to bargaining power, unless you are fortunate enough to belong to a union, you have zero bargaining power. Even if your employer offers some sort of HMO at work you have little or no say in the services you will be offered or the costs for those services that you will be enrolled in. Your ability to negotiate the very best policy simply doesn't exist. And more's the pity if you come to table with any disability suffered prior to being insured. Pre-existing conditions can raise the cost of a policy to a level far out of reach for the vast majority of Americans.
Lastly, since the cost of medical care has increased far faster than any other area of the economy, you have no choice but to pay whatever is asked for health insurance. If you can afford it, you have to buy it. If you can't afford it, then the decision has been made for you and you will be forced into the ever circular process of having to wait until your condition worsens to the point that you must seek treatment through the emergency room at your local hospital and then continue that course of action since you cannot afford the necessary drugs and follow up visits that may be required. Thus, while the initial visit to the ER may help you, any further problems must again wait until they require emergency assistance. You have no choice about whether or not you pay for a HMO policy. The only factor is whether you can afford one or not.
As Mr. Sage points out, while we can claim to have the world's best health care available, it does you no good unless you "have the money, live in the right geographic location, are a smart consumer, and have a medical condition that makes medical research lucrative." Otherwise, you may as well be living in the most forlorn Third World country imaginable.
One can extend this line of thinking to just about every segment of our lives and the nation's economy. Higher education, employment opportunities, affordable housing, and many other areas of our lives are governed by the five basic principles. The further that the world is forced into the wet dream of business, the Global Economy, the further away we will find ourselves in any hope of maintaining a say in our futures or even our present conditions. The lie of the competition in the marketplace serves only to greatly limit your choice of products and services more and more with each passing merger or corporate takeover. The system is rigged against us and the future looks very, very bleak. ( 1 )
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