Is Health Care a Commodity?

As the left and right blast each other concerning health care, a major question remains unanswered.

Clarke E. Cochran, Ph.D., Professor of Political Science at the Department of Health Organization Management at Texas Tech University, will deliver an address entitled "Seeking Justice: The Imperiled Promise of Healthcare Reform" at The Center for Public Justice's 15th annual Kuyper Lecture on October 22 in Washington, D.C.

10 years ago, before all the heated town hall meetings and all the left- and right-wing media pundits started spouting off on this, he addressed health care reform at a presentation given at Calvin College.

In this address, Cochran raised this critical question: Should we view Health Care as a commodity?

"Different spheres of society appropriately employ different bases of distribution. College professors aim to assign grades on the basis of merit or achievement. The same principle is used for prizes in an athletic competition. Parents distribute slices of cake at a child's birthday party according to strict equality, lest fights break out. Numerical equality governs votes in a democratic society. Cameras, blue jeans, automobiles, pencils, and diamond rings are distributed according to the logic of the market.

Need is the proper principle for distributing health care because health is necessary for a community's proper functioning. Good health facilitates social interaction and economic enterprise. Medical care is one of the principal means to preserve and restore physical, mental, and emotional functioning. Therefore, all societies (except the United States) that value health and that have the financial and technical means to develop modern systems of medical care recognize that health care for all citizens is a matter of public justice.

The prime competitor of need as a distributive principle is the market. Commitment to laissez-faire capitalism promotes a vision of the market as the single metaphor for life. Yet the market, however appropriate for the distribution of commodities, depends on an individualistic perspective foreign to commitment to the common good. It treats health care as a commodity like cameras, cars, pencils, and blue jeans. Those without financial resources receive inferior care or no care at all. The American tendency to make health care a market commodity produces very high quality technical care, but at the highest cost and worst access in the modern world."

The flip-side of the argument is this: A market-driven system properly places responsibility on the shoulders of the consumer, rather than on an impersonal bureaucratic entity. Markets produce the best product at the best cost because producers must respond to the demands of consumers. Our health care system must honor the image of God in each human being, meaning that we must care for the needs of each human being while we also honor the dignity of each human being by not robbing them of personal responsibility. Cochran talks about this as well (we’ll look at this in a few days).

So, before we can get into the nitty-gritty of policy, a foundational question needs to be addressed: Should we view Health Care as a commodity?