Commentary: Health care does not have a free market solution

Source: Salt Lake Tribune

I want to talk to anyone who thinks the free market is the answer to our health care crisis.

What is the free market? It’s a transparent and competitive marketplace where a willing buyer and willing seller can engage in an informed transaction. Sounds like buying a cellphone, a car, even a house. But health care? Be serious!

Look at this through my eyes. I’ve always had insurance, employer-provided, gold-standard stuff. I’m a lawyer, married to another lawyer. So statistically, maybe 2 percent or 3 percent, of the population are in our health care shoes.

I’m from Chicago and I was a road biker. I loved to ride my bike along Lake Michigan. It’s flat along Lake Michigan but I researched Chicago hospitals to figure out where to go if I had a bike accident. No, of course I didn’t do that.

But one day I’m in Utah building my dream house and riding away from the site at 50 mph. Only it’s not flat. I’m on a hill. A really big hill. My front tire came loose and I remember thinking, this is going to hurt.

After the fire department scraped me off of Wasatch Boulevard, I woke up at Alta View Hospital, in and out of consciousness, several procedures gone by, doctors and nurses everywhere. There was no discussion about what my insurance would or wouldn’t cover; no research about the cost of an MRI or CT scan; no research about the plastic surgeon who will try to restore what used to be my skin. There was saving my life and providing me the best care the facility and its doctors and employees could provide.

I’m also a skier and, as I apparently like to get really hurt, I was out for a nice ski day at Snowbird some years ago with one of my kids and some friends when one of my skis caught on something, and I went flying. If you’re a skier, you’ve probably done it. Multiple times. But this time it’s different. I heard my leg snap as I cartwheeled through the air. By the time I landed and ski patrol came to my rescue, I had five broken bones. Oops.

So it’s off to the Snowbird Clinic (terrific, by the way!) and then, after stabilizing me, it’s back to Alta View (my old stomping ground!). I’m full of narcotics, so they don’t ask me if I prefer Uber or Lyft. Nope. They called Gold Cross Ambulance who, because it’s a free market, charged $1,500 for the non-emergency 10-mile drive from Snowbird to Alta View.

As I’m pretty sure Alta View sees its share of patients from Snowbird, I wasn’t thinking about researching hospitals for my surgery when in comes the on-call doctor who explained what he thought we should do. It involved a graphic description of some screws, a metal rod and tools that sounded like I could get them at Home Depot rather than in the hospital. (Surely they’d be cheaper at Home Depot.) So I say hold on, let me see if I get a rod and four screws put into my tibia on Amazon Prime – hell, I can wait two days! But, no such surgery is offered on Amazon Prime so I tell the doctor to go ahead.

Along the way, premiums were paid on my behalf. No one mentions what anything will cost. (Those screws were almost $1,000 and when they come out, I can’t even resell them on eBay!) I didn’t know who was in- or out-of-network. I didn’t know who my insurance company negotiated with, what my insurance would cover, and if I’d owe a balance or not. I dealt with the hospital, surgeon and anesthesiologist. And the ambulance company.

And this is my experience in the health care market. Did I mention that this was all before Obamacare? Me — I’m annoyed. I have bills I don’t understand, hours are spent figuring out if I owe anyone money. Hundreds, thousands of dollars out of pocket. And there’s no way I’m paying $1,500 for that ambulance ride! But I didn’t lose my job. I didn’t go broke. I didn’t declare medical bankruptcy. I didn’t have to choose between paying these bills or paying the rent or feeding my kids.

So if you want to talk about fixing the health care system, let’s do it. But if you believe the free market is the solution to our health care problems, please explain where I went wrong with my economics and law degrees. And you better come at me with more than your tattered copy of “Atlas Shrugged.”

Josh Kanter lives in Sandy. He’s the founder and board chair of the Alliance for a Better Utah.

 Read Salt Lake Tribune Op-Ed here
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