Letting "Immoral Profit" Get in the way of Health Care

In the Middle Ages, Western culture had the same "anti-profit" mind set regarding usury. Church doctrine at the time was that usury was immoral and therefore forbidden to Christians. The zeitgeist at the time was that profiting from the lending of money was immoral. Jews, not being part of the Christian religious establishment, where not bound by such strictures. This, combined with Jews being bared from the conventional trades of the time essentially pushed them into usury. I think a compelling argument could be made that the advent of usury gaining a toe hold and it's implementation by the Jewish community was a significant contributing factor to making the Renaissance possible by making available the financing required to drive the Renaissance. The point being that the Renaissance was made possible by getting past the notion that usury for profit was "immoral" and accepting it at least a unnecessary evil to improve the quality of life. And the corollary then is that regions that did not have access to the for-profit-lending of Jewish usury were at a developmental disadvantage as a result.

In modern times we have seen what the engine of profit opportunity in competitive free markets can achieve. And what's more we have "experimental controls" against which to compare. In scientific endeavors, experimental validation of a theory requires not only demonstration that the theory in fact produces the predicted results, but also "control sets" that demonstrate that absence of the theoretical mechanism does not produce similar or contrary results. We are well aware of the notion of "double blind trials" in medical pursuits used to validate new therapies. We have the same situation available to us for the study of market economics, if; however, not quite as rigorous as in a laboratory environment. Our market enabled consumerism has product some of the most vast leaps in technology and production. Two glaring examples are the production of automobiles and food. The stark contrast between Eastern European and Western produced autos is staggering. We have any number of manufacturers in the west that have produced the most advanced, quality, affordable, and widely available autos the world has today. Eastern European, non-market communist economies have been unable to produce anything remotely comparable. Some of the examples that we are familiar with are such as Yugo, Trabant, and Volga, cars of notoriously poor design and quality. The opportunity to make a profit in a competitive market has provided the economic engine that has produced the cars we have in the West. The absence of the opportunity to make a profit in a competitive market has produce the likes of Yugo, Trabant, and Volga.

In the production of food, profit opportunity in competitive markets has produced a food production powerhouse that feeds not only itself, but a large portion of the rest of the world. When we look at countries that deny to opportunity to make a profit in providing food, we see countries barely able to feed themselves with pitifully bare market shelves. Anecdotally, I know many people that have come from various parts of Russia and one of the things that was most shocking to them in coming to the US was the abundance of food on market shelves. They were astounded not only by the sheer abundance but also the vast variety from which to choose. And we have other illustrative examples that are virtual lab experiments. Many countries view profit making in the production and providing of food to be immoral, much like usury was viewed in the Middle Ages, and health care is viewed today. On one hand we have Cuba. A principle food distribution mechanism is the kind of "community farmers markets" where, basically, the food producers go to sell their products. In Cuba they have introduced (free markets) along with the customary government regulated markets where, well, everything is regulated by the government. In the more or less "free" markets (with some constraints) farmers are able to sell "excess" at market rates. The difference between the two is stark. The "free" markets are better stocked and with higher quality food than the regulated markets, and the prices and not dramatically different. And the people much prefer shopping at the free markets as a result of the availability and quality of the wares. Naturally this creates tension with government as a preference for "free markets" over government markets is anathema to a communist regime. On the other hand, we have Venezuela that is taking the opposite tack going from market based to government controlled. Before government controls, food availability, quality, and pricing was much like any other market based country. Now, after having government controls imposed, with the overt and stated goal of eliminating "immoral" profit opportunities as a result, many items, especially staples such as dairy, are in short supply and shelves are mostly bare. Needless to say, many Venezuelans must resort to black markets to get basic food supplies. The question becomes, which is more immoral: the making a profit in providing an essential product or making that product unavailable as a result of preventing the making of such profits?

The point here is that we should not fall into the trap of profit being "immoral" and the inability to get past that so that it effectively hamstrings our ability to reform health care so that it provides the best medical care possible. The opportunity to make a profit lending money fueled the Renaissance. The opportunity to make a profit has fueled the most advanced, abundant, quality, and affordable consumer products, such as cars and electronics, the knows today. The opportunity to make a profit providing food feeds the world while citizens of governments that prohibit "immoral profits" are starving. We can look all around the world and see that profit opportunity in competitive free markets pretty much universally outperforms government controlled and operated markets in quality, availability, affordability, advancement, and growth. Yet so many people can't get past the notion that profit is immoral and should not be allowed in the providing of health care. It's as if these people seem to think that the economic principles and realities that govern every other market known to man should somehow not be in effect in the health care market. This is like thinking gravity should or would somehow not apply if you are falling off of a cliff, because it would be immoral for gravity to cause your death. No matter how earnestly you hold such beliefs, that can't make laws of nature or laws of economics not apply simply because you are uncomfortable accepting the reality that is at odds with your ideology.

The typical counter argument is how "wonderful" European health care is. First I would say, that is debatable and there is evidence to the contrary. Secondly I would say that if you don't have a car, a Trabant might seem similarly "wonderful." That doesn't make the Trabant the best possible car. And it is argued that our health care is inferior. Again I would say there is evidence to the contrary. I would also say that there is no real basis to assume that the European model would necessarily produce any better results here as outcomes are not solely determined by the provisioning models, but also the population to which they are applied. If the populations are dissimilar, then it is unreasonable to assume identical results. Also, if you look at the segments that do in fact operate as true free markets, those segments actually outperform European models. Where the US system falls apart is in areas that do not operate as free markets, often as a result of government or anti-market meddling. It is also argued that European models manage to deliver decent health care. There is no argument about that. Yugo, Trabant, and Volga also manage to produce drivable cars that get people where they are going. However, just because cars made by Yugo, Trabant, and Volga manage to get people where they are going, do you want to limit yourself to products of that caliber or do you want products of the caliber produced by companies operating for profit in competitive free markets. The crux of the argument against government run health care is that I would prefer to have "Toyota" (high quality, widely available, technologically advanced, and affordable) health care rather than be limited to "Yugo" health care. The only way we can have "Toyota" health care is if people can get past the "immorality of profit in health care" ideology. If we cannot get past the "profit immorality in health care" ideology, our ability to advance health care development, expand availability and reduce cost will be severely limited. The net effect on health care as a result of eliminating free market economics and imposing government controls will be exactly counter-productive and in opposition to achieving to the stated reasons for doing that. It took getting past the "profit immorality of usury" ideology to make the Renaissance possible. Regions that couldn't were at relative disadvantage as a result. It takes getting past the "profit immorality in food production" ideology to allow free markets to feed the world better than government controlled markets. Citizens of governments that can't go hungry as a result. It takes free markets to produce the caliber of goods and services that we take for granted. Governments that restrict markets are held at a disadvantage and relegated to producing inferior goods and services.

If government controlled markets are so great, why are people in countries with government controlled markets chronically unable to adequately feed themselves or at least unable to eat anywhere near as well as people in countries with free markets to provide their food? The best health care reform would be to leverage into health care the same market forces that has been the engine of development that has provided the highest caliber products in other markets. But in order to do so, people must get past the "profit immorality in health care" ideology. We can see for ourselves the resulting benefits of free markets in advancement, quality, availability, and affordability in every other market yet people cannot make the leap in understanding that, economically speaking, health care is just another product or service just like any other. Just like gravity does not distinguish whether the object falling off of a cliff is a rock or a person: it produces exactly the same effect either way; laws of economics are no different: it makes no difference whether the product is big screen TVs or health care, the effect is the same. Leveraging free markets in health care would produce the same benefits it has in every other market and that preventing the natural free market from working will only produce the same disadvantages and developmental retardation that doing so has produced in every other market. Government controlled economies can produce cars too, but would you prefer a Western made car or a car made under a government controlled economy? Now ask the same question but health care instead of cars. How can you answer any differently?