The present outbreak of measles tells a sad story of the impact of market forces on American healthcare.
As of May 30 of this year, the CDC had confirmed 334 cases of measles nationwide. To put this in perspective: We have had more cases of measles in the first five months of this year than the total number of cases for any year since 1994. I blame market forces.
Market forces: Forces of demand and supply representing the aggregate influence of self-interested buyers and sellers. Market forces: That conservative political panacea of how to fix healthcare is, in reality, turning the United States, and the world, into the 2011 blockbuster Contagion.
This is important to understand: There are realities in which market forces fail. The classic example is the tragedy of the commons in which local farmers let their sheep and cows overgraze on a common field. Eventually there is no field left for any animals to feed on. The population becomes sick and dies. End of story.
It seems simple to me, yet it’s an argument I have with conservative colleagues, anti-vaccinators and, yes, a few physicians, again and again. In the tragedy of the commons, the individual farmers acted in their own self interest; their cows and sheep needed to eat, and there was the grass in a public space, so they took their animals to graze without thought of others, or even for their own future needs. When individuals, motivated by immediate self-interest, cause harm, this is a failure of market forces and smart regulation needs to be established and enforced.
Similar to the tragedy of the commons, the current measles outbreak is especially sad since it had been predicted by many pro-vaccine leaders in our community. Anti-vaccinators, motivated by immediate self interest, have put us all in jeopardy. Be it thoughtless farmers or anti-vaccinators, market forces fail when it comes to public goods.
As I’ve blogged before, we are being harmed by healthcare and political leaders who do not recognize the significance of public health issues when they set agendas and policies. Case in point: A current best-selling book compares top hospitals to Microsoft. This is ridiculous.
Microsoft created paradigm-shifting technology and made a bundle selling to Fortune 500 companies. Hospitals have to treat the neighborhood homeless man with schizophrenia and drug-resistant TB. In the high-tech world, there are profits and losses, winners and loser. In healthcare, there are just losers when preventable disease is spread in our community.
What am I doing about this? I write. I vote. I talk. And so should you! If you disagree, rent Contagion for your next movie night.