CAPITALISM AND HEALTHCARE: MORALITY AND COMPETITION

Healthcare.

Isn’t it a moral issue? The Hippocratic oath of the physician?

Isn’t it a social issue? The obligation of the State to care for its citizens?

The right of the covenanted citizens to receive medical help in case of illness and other medical conditions?

So, what does capitalism have to do with it? Isn’t the basic nature of capitalism – profit-making – inimical to all of the above: the physician’s oath to treat any patient no matter what, the state’s responsibility to provide medical help, the citizen’s right to receive medical help unconditionally?

This is what I hate about the question of healthcare in principle. Yes, please, take care of the physicians, so that in their noble selfless task of healing people they would be well provided for. So that the capitalist urge for profit would never pollute their honorable profession.

There is no wishful thinking here. The practical thinking on this subject is built into the system of remuneration for public officials. The President of the United States, even after substantial pay increases of recent times, still gets less than an average executive in the private sector. Elected public officials are paid quite enough not to want, yet not too much to want the job for money’s sake. The endemic curse of public office corruption is a human weakness not written into the job description. Public office is supposed to be a genuine vocation, a person’s higher goal to serve society. Profiting from public office is supposed to be considered a crime.

So, let us make the office of the physician a public office. Is that too much to ask?

In normal capitalist practice, competition is an essential ingredient. Making money is the main objective. Morality is only a limiting factor, a restraint on the temptation to excel at its expense.

Healthcare ought to have a different set of priorities, and money-making must not be among them. This is not merely a desideratum. This ought to be the underlying principle of healthcare in capitalist society. Indeed, in any society.

Alas, my argument sounds too idealistic even to me. There must be something very rotten in the whole social attitude to healthcare in American society. Instead of arguing which system is better for the patient: the standard system of competition among the providers or the so-called “Obamacare,” let us recognize that the two acknowledged “competitors” are nothing but the two sides of the same coin.

At issue here is not the technical means of providing healthcare, but the philosophical principle underlying it. Healthcare is a question of morality, not of economics. Capitalist competition must have no part in it.

So, will a corrupt health provider cease to be corrupt, should he become a public official? By no means! But just because human nature is corrupt, let us not corrupt the idea.