From: Travis
Subject: Private-Sector Health Care Leads the Way
Date: Wednesday, December 3, 2008,

  Christmas Sale on Rothbard's *Conceived in Liberty*: Purchase a Set
Today<http://www.mises.org/store/Conceived-in-Liberty--P96.aspx>
. Private-Sector Health Care Leads the Way

*Daily Article* by Chris
Brown<http://mises.org/articles.aspx?AuthorId=1138>| Posted on
12/3/2008
 It is easy to criticize the US healthcare system, but we should be clear on
one thing: it is not "free market" or "private" healthcare. A free market in
healthcare *would* be more efficient and innovative, and offer better
quality products and services, with lower prices than is currently the case.
In addition to the US government's obvious socialist interventions with
programs such as Medicare <http://www.medicare.gov/> and
Medicaid<http://www.cms.hhs.gov/home/medicaid.asp>,
there are a multitude of other measures that hinder innovation in healthcare
— and we can expect only increased involvement under
ObamaCare<http://origin.barackobama.com/issues/healthcare/index.php>
.
While socialists point to the "failures" of the US healthcare system and, by
some magical feat of legerdemain that merely exposes their (economic)
ignorance, attribute it to the "free market," it is crucial for
Austrolibertarians <http://www.austro-libertarian.com/> to point out the
absurdity of this false reasoning.
For example, the US government accounted for over
45%<http://austro-libertarian.com/us-healthcare-is-not-a-free-market/>of
all US healthcare expenditures in 2006; it spends almost
20% <http://austro-libertarian.com/us-healthcare-is-not-a-free-market-ii/>of
GDP on healthcare; indeed,
*it spends more per capita than any other OECD country* (see Figure 1),
including those with socialist, government-funded healthcare. In short, this
is *not* a free market.
 *Figure 1. Per capita government expenditure on health 1995–2006 (PPP int.
$)*
 Source: World Health Organization
Data<http://www.who.int/whosis/indicators/compendium/2008/3exo>
We can quickly list a few of the myriad government and other regulatory
programs that keep prices high and stifle innovation: the Center for Disease
Control and Prevention <http://www.cdc.gov/>, the Food and Drug
Administration <http://www.fda.gov/>, the American Medical
Association<http://www.ama-assn.org/>,
the United States Department of Health and Human Services<http://www.hhs.gov/>,
etc. One reason healthcare costs are so high is because the industry is
subsidized; and one reason government intervention only grows is because you
can expect more of anything that is subsidized. Doctors and physicians raise
their prices on those paying privately to cover those who do not pay, i.e.,
those the government pays for through theft, a.k.a. taxes. Government is a
poor individual's (and everyone's) worst enemy, or at least should be when
recognized for what it is and does. Fortunately, there are entrepreneurs who
compete in the healthcare industry, despite government's attempts to hinder
competition.
Wal-Mart and Healthcare Private companies that are allowed to do business
without government intervention (and without being granted a
government-sanctioned monopoly) must offer better-quality services or lower
prices to continue to attract customers. One example of a company that
consistently offers both better-quality products and services *and* lower
prices is Wal-Mart. Even Wal-Mart's
critics<http://en.wikipedia.org/wiki/Criticism_of_Wal-Mart>typically
agree that it is
*always* about low prices.
Indeed, many governments have issued antitrust
cases<http://www.newrules.org/retail/news_archive.php?browseby=slug&slugid=165>against
Wal-Mart for charging
*too low* a price (so-called "predatory pricing<https://mises.org/story/226>").
Because of the threat of antitrust prosecution — and especially given that
antitrust laws are so vaguely defined — businesses are more fearful of
taking on risk, and less efficient in serving the consumer.
Fortunately, however, Wal-Mart has continued to grow and has recently ventured
into the healthcare market<http://walmartstores.com/HealthWellness/7613.aspx>
.[1] <http://mises.org/story/3233#_edn1> While the US government adds more
bureaucracy and money to the healthcare situation, private companies such as
Wal-Mart are innovating and bringing the blessings of healthcare to many.
Wal-Mart has given access to lower-priced, affordable products to "poor" and
millions of uninsured individuals. They are the world's largest (private)
employer, with over two million employees serving over 200 million customers
a year. Sam Walton <http://en.wikipedia.org/wiki/Sam_Walton> should receive
a Nobel Peace Prize<http://nobelprize.org/nobel_prizes/peace/laureates/2008/>for
his efforts, which have lifted
millions out of poverty <http://www.nwanews.com/adg/Editorial/170118/>, and
continue to do so.
Wal-Mart now offers walk-in, inexpensive healthcare services by leasing
store space to private health clinics. This service, combined with an
in-store pharmacy that offers $4 prescriptions, will offer these services to
*millions* of people, and there is no requirement to have health insurance.
Consider this: *Wal-Mart's $4 prescription program has saved customers over*
*$1 billion dollars* <http://walmartstores.com/FactsNews/NewsRoom/8124.aspx>
* since its inception*. Prices are a flat fee of around $45 per visit, and
are well advertised, i.e., there is no guess work, and price transparency
exists. Contrast this with a typical doctor's visit where you might not know
what you are paying until three months later.
>From Wal-Mart's website <http://walmartstores.com/HealthWellness/7613.aspx>,
we read the following:

 Our retail clinics are an especially valuable resource for individuals
without health insurance. Nearly half of all clinic patients report that
they are uninsured. *Many visitors have said that if it were not for our
clinics, they wouldn't have gotten care — or they would've had to go to an
emergency room*. By visiting one of our clinics, patients receive the care
they need and at the same time reduce overcrowding in emergency rooms and
eliminate the costs of unnecessary hospital visits. (Emphasis added.)

There are significant effects and
benefits<http://www.rncentral.com/nursing-library/careplans/20-surprising-ways-wal-mart-clinics-affect-us-healthcare>that
can be attributed to Wal-Mart's innovation in healthcare services. For
example, Wal-Mart offers faster service and treats common illnesses,
fostering a greater specialization and division of labor. This will allow
doctors to specialize in more complex problems; and yet some physicians are
(correctly) 
worried<http://trusted.md/blog/dr_rob_lamberts/2006/05/15/attention_doctors_wal_mart_offers_low_prices>since
they will have to struggle to compete with Wal-Mart's healthcare. Most
physicians earn their revenue from "quick" visits — the "simpler" the
illness, the quicker the visit — which means more customers, and more
revenue. Wal-Mart will now be treating those patients and receiving revenue
from customers, which formerly would have gone to physicians.
Similarly, the AMA cartel
<http://www.aapsonline.org/press/nraapslott.htm>could receive a
"prescription" from Wal-Mart on learning how to foster
innovation, as opposed to stagnation, to maintain relevance. Other
organizations, such as the American Academy of Pediatrics, instead of
attempting to compete, intransigently and stubbornly cling to their
antediluvian practices by merely writing position papers opposing retail
clinics such as Wal-Mart.[image: Download
PDF]<http://www.aap.org/advocacy/releases/rbc.pdf>
Indeed, almost any healthcare service will have to lower its prices to
compete with Wal-Mart. Competition will likely increase and there will be
more healthcare and retail clinics that offer similar services at
competitive prices. The more profits that Wal-Mart obtains through this
service, the more competition there will likely be to strive for a portion
of consumer's money — thus we see the important function of profits in the
economy. Typical public opinion has the causal link exactly backwards: the
more profits a company earns (in a free market), the better it is serving
its consumers, i.e., the more they are demanding its services. They should
be exalted for their efforts (and profits), not condemned.
 <http://www.mises.org/store/Profit-and-Loss-P540.aspx>
In the spirit of competition, self-interested entrepreneurs will strive to
serve the consumer better than their rivals. This will result in more
affordable healthcare for more people — something the government could never
achieve, regardless of any mixture of force, money, and bureaucracy; in
fact, any government intervention will only stifle this "healthy" process.
The market, to the extent it is able to work freely, would lower healthcare
prices while increasing quality; to the extent that government is involved,
expect higher-priced and lower-quality services — and more
bureaucracy<http://mises.org/etexts/mises/bureaucracy.asp>.
Wal-Mart and other retail clinics <http://www.minuteclinic.com/en/USA/> have
raised the bar for competitors by lowering costs and innovating. In a world
where government power is growing and seizing — and ceasing — liberty, and
suppressing innovation that takes place in a free market, private companies
such as Wal-Mart that continue to take risks and innovate provide hope for
the future.
[VIEW THIS ARTICLE ONLINE] <http://mises.org/story/3233>
 ________________________
Chris Brown is a lecturer at the Australian Graduate School of
Entrepreneurship at Swinburne University. He also centrally plans the
Austro-libertarian
blog <http://www.austro-libertarian.com/>. Comment on the
blog<http://blog.mises.org/archives/009047.asp>
.
 Note [1] <http://mises.org/story/3233#_ednref> There is the
possibility<http://money.cnn.com/2007/02/07/news/companies/walmart_healthcare/index.htm>that
Wal-Mart will "partner" with government to offer "universal"
healthcare
coverage. If this unfortunate and disappointing event comes to pass, an
article critiquing the adverse effects of public-private partnerships—and
castigating Wal-Mart—will be necessary.
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