I keep encountering discussions of health economics in which patients are referred to as “consumers”, after which the usual mantra of freedom of choice is invoked on behalf of voucherizing Medicare, or whatever.This is an excellent and very pointed commentary on what has gone wrong under the dominance of right wing "free market" thinking with the idea of "let the market decide because it is all knowing". It isn't. It is a blind beast. Worse, it is a beast without an ethics. Nature is indifferent to human values. We impose our ethical vision on the world. To let "markets decide" is to turn this relationship upside down and put people at the cruel and indifferent forces of nature. Our ancestors invented superstitions, religions, and ethics to deal with the cruel indifference of nature. To let right wingers return us to that blighted time is purely insane.
We used to know better than this.
Medical care is an area in which crucial decisions — life and death decisions — must be made; yet making those decisions intelligently requires a vast amount of specialized knowledge; and often those decisions must also be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping.
That’s why we have medical ethics. That’s why doctors have traditionally both been viewed as something special and been expected to behave according to higher standards than the average professional. There’s a reason we have TV series about heroic doctors, while we don’t have TV series about heroic middle managers or heroic economists.
The idea that all this can be reduced to money — that doctors are just people selling services to consumers of health care — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values.
Wednesday, April 20, 2011
A Society's Ethics
Here is a very important post by Paul Krugman on his NY Times blog: