Reprinted from Campaign For America's Future
Financial columnist Megan McArdle recently wrote a column entitled "Healthcare Is a Business, Not a Right." She was responding to a tweet from financial writer Helaine Olen:
25. The health of Americans should not be a profit center. Health care is a right. Full stop.
Health care is a business, says McArdle, but most of us aren't tough-minded enough to admit it. Even if you ask a conservative, she writes, "there is a good chance you'll get a rant about greedy insurers nickel-and-diming hardworking consumers when they're sick."
"Almost everybody feels that there is something fundamentally wrong about making money off someone else's illness," McArdle laments.
It's a straw-man argument. Nobody I know thinks there's something "fundamentally wrong" with doctors or nurses earning a living, or pharmacies turning a profit. Doctors, nurses and corner pharmacists are iconic figures in American folklore.
McArdle misrepresents her adversary. Olen's tweet begins with the number "25," which McArdle omits, meaning it's the 25th in a series of tweets. The full series makes it clear that Olen is talking specifically about health insurance. Olen's "full stop," which McArdle mocks, seems intended to signal the end of her twitter essay.
But then, you can't make a straw man without breaking some straws.
"No, don't sputter and tell me that it's obvious, that people need health care," McArdle writes. "People need a lot of things. You'll die without food long before you'll die without healthcare, and yet few people say we need to 'take the profit motive out of farming.'"
Nobody's sputtering, but the farming analogy is poorly chosen. Food production and health care delivery occur in very different economies. The need for food is consistent, stable, and predictable. The need for health care varies dramatically over time. Insurance, whether public and private, spreads risk among larger groups and levels out its potentially devastating cost spikes.
But, while farmers provide food, insurers don't provide health care. They're intermediaries. When they're profit-driven, their economic incentives can become socially destructive. Other for-profit health intermediaries include pharmaceutical companies and third-party investers like Bain Capital, who invest in medical providers and then press them to maximize profits. (See "Sick Money.")