Thursday, January 17, 2008

Health care culture

Mary Beth Regan dredges up a number of interesting ideas about our health-care system in the Johns Hopkins Public Health magazine. Here's one, from JHU health policy prof Thomas A. LaVeist:
more tightly regimented treatment protocols to level the playing field. "The one place we don't find racial or ethnic disparities in health care is in the active-duty military," he says. "In the military you don't have black culture or white culture, you have 'green' culture," he says.

"When the lifestyles, health care access, and practice are similar, the outcomes are similar," he says. To LaVeist, U.S. experience shows that health care does not flourish when left to a free market. "There are public goods and services that are not optimally distributed by the free market—for example, police services, emergency services and national defense," he says. "Health care may also be one of them."

This reminds me of No Child Left Behind, for better or worse. Some teachers kick and scream because that law, or some small-minded implementations of it, have reduced their professional discretion. Medicine is both better organized and much more professional (in the sense of a learned profession) than education, so I don't know that this particular proposal is going anywhere.

But professionals -- in health care or education or whatever -- who abhor the idea of "more tightly regimented treatment protocols" might want to be involved in profession-based attempts to bridge cultural and economic gaps, rather than fighting efforts to correct them.


prb said...

"U.S. experience shows that health care does not flourish when left to a free market."

This seems a very odd statement -- what U.S. experience shows this? When in this country has health care been "left to a free market"?

JB Powers said...

While the FDA rejects news drugs because they could cause "unhealthy price competition" and the Mob runs the Illinois Healthcare Facilities Planning board, and the AMA stops Target from opening low cost clinics in poorer neighborhoods, no one in their right mind can think that there is currently a free market in healthcare.

Harold said...

Thanks for pouncing on that part, guys. If we all three agree, we surely must be right!

I'd say the current system's the result of decades of special-interest muddling, and in some areas a freer market could hardly work worse. Whether that could be *the* solution, I defer to people who have time to investigate and think about it. Some level of health care may be sort of like water -- it is a commodity, but it's a commodity that (unlike filet mignon or nice cars) we feel distinctly uncomfortable about denying to those who can't pay the freight.

prb said...

It's not just "can't", it's also "won't". Initial results with Massachusetts' new universal-health-insurance system seem to support the argument that somewhere around half of those now being counted as lacking health insurance are actually able to purchase it but simply declining to. So, apparently, rather than 15% of Americans being unable to get health insurance we have maybe 8% who are unable and 7% who are able to have it but simply uninterested.

arun said...

Health care policy is a very nice policy. So it is provide various services which is related to health.

arun said...
This comment has been removed by a blog administrator.