Two America Syndrome: "Patients Are Not Consumers"

While many of us were doing a victory lap after the smacking down of the Wonkette blog yesterday, our favorite Nobel Economist turned blatant left-wing shill, Paul Krugman, came out with a brief editorial entitled “Patients Are Not Consumers”.

Now, maybe to you and me this statement is a total brain aneurysm, but then again, Mr. Krugman is still somehow taken seriously by large segments of the population, and the initial reader comment, expressing incredulity that Mr. Krugman would have to explain something so obvious, tells me we have another case of Two America Syndrome at work here.

(I should explain Two America Syndrome, given that’s a term I just made up.  Basically it’s a callback to my earlier blog entry on the lack of empathy in this country, and how we’re devolving into two cultures that are losing the ability to even understand how the other half thinks.)

Let’s give Mr. Krugman a chance to explain.  Essentially, what he appears to be saying (and please read the linked editorial for yourself to judge for yourself if I am not mischaracterizing) is that because there are certain health care situations, mostly involving emergencies, where the patient is unable to make choices for themselves nor has anyone to do so on their behalf, that this somehow makes all healthcare decisions similarly involuntary.

Sorry, I swear I’m trying here. I’m usually pretty good at this, but my Nobel-Laureatese seems to be a little rusty.

Let me try that again.  Krugman takes a situation that hopefully rarely — and if we’re fortunate, never — comes up over the course of our lives, and decides to paint that as encompassing all of health care.  Because these situations occur, where you may find your life in the hands of a doctor you’ve never met, with nothing to guide him or her but experience and ethics, that somehow disqualifies all of healthcare as a service to which such crass concepts as cost savings can apply.

There. I’ve done my best to paraphrase the man. Should he or any of his readers have any further complaints, they may feel free to leave a message.

And now, because one explanation of something that should be obvious deserves another: incapacitated emergency care is a very small part of the overall healthcare system.  A very expensive part for its size, to be sure.  But let’s be plain: you and I do not have life-threatening emergencies every day, or likely even every decade.

No, health care is far, far more than the very specialized case Krugman attempts to portray as the be-all and end-all of the industry.  The simple truth is that most of the time we do make our own health care choices, we do shop around, we do decide for ourselves what we need under given circumstances. That is the essence of a properly functioning health care system.  Yes, Mr. Krugman, sometimes it happens that health care choices have to be made for us, but in a free country those cases are the exception rather than the rule, and forming policy based solely around such cases is faulty logic at best and more than likely simply disingenuous.

Krugman closes his short piece with his usual handwringing about why this health care debate has to be about (pause to grimace) money. Well, Mr. K, in case you hadn’t noticed, the actual quality of health care in this country is pretty well the best anywhere.  There’s a reason why anyone who can afford to do so will take advantage of the health care services our country has to offer.  We focus on cost because that’s the problem.  Piously declaring that it because extreme cases occur where cost considerations are rightly set aside, therefore it’s always wrong to take cost into consideration, is a condition with a simple diagnosis: lazy thinking.

UPDATE: Ben Domenech has another, apparently more front-page worthy piece on the same topic.