Practical Healthcare Markets are Still Possible

Today's healthcare has become one of the more important economic factors which exacerbate political division in the U.S. But how has healthcare's present organizational capacity, contributed to this result? These thoughts were on my mind as I recently began reading "The Social Transformation of American Medicine". Even though the book was published more than thirty years ago, much of what it details, still appears relevant now.

Lester King in the above JAMA link, gave a favourable review of Paul Starr's book, and his quibbles were mostly minor. Among King's concerns, was Starr's generalization of certain historical factors, Likewise, my first impression is that Paul Starr may have overly generalized healthcare's level of authority over citizens and other disciplines. Nevertheless, enough authority exists, that more citizens now seek healthcare as defined by professional specialization and deep learning, than practitioners are actually able to provide.

Little more than a century ago, scarce anyone had reason to complain about supply side limits, since lay practitioners from all walks of life were still at work - especially in rural regions where doctors were few. Among the lay practitioners who were most effective, were those who emphasized the botanical remedies which were ultimately absorbed by the healthcare of our time. While botanical remedies were once a major aspect of rural self sufficiency, the practitioners who continue to emphasize botanical remedies now, are mostly found in prosperous cities with little access to rural America.

Individual autonomy has preserved the ability of physicians to undertake deep learning which requires extensive education and commitments for human capital investment. I certainly respect their desire for autonomy, their ability to provide a quality product, and their wish to live and work wherever they desire. However, the healthcare marketplace which exists today, is mostly available for individuals who are still able to assume active roles in city life. Since our government is quickly becoming less able to reimburse individuals who cannot fully reciprocate for healthcare, and many rural citizens remain in an excessively dependent state, physicians may eventually seek means to deal with this major societal issue.

Fortunately, it is possible to generate a more practical healthcare marketplace, even as physicians seek to preserve their hard won autonomy. We could create new organizational patterns which make divisions of "labour" that require deep and extensive learning, less of a necessity. One way to accomplish this is through time arbitrage, in which the purchase of time value for time value, does not pose issues for the price points and human capital investments of today's healthcare.

Addressing supply side deficiencies is vitally important, especially for those who lack for the resource capacity or income to fully compensate deep learning requirements. Given the fact automation proceeds apace with both deep learning and learning specific methods, learning specific methods for individuals would certainly be a reasonable approach. Since only about a quarter of today's workforce has the well compensated work with benefits that is capable of supporting deep learning, and insurance can't absorb the difference, it's time for a new approach, to practical forms of knowledge use.