Patients Are Not Consumers? Krugman Strikes Again

Patients are not consumers, says Paul Krugman, a man so consistently wrong as to boggle the mind. Krugman hates most anything that fails to make government bigger and more intrusive, so it is no surprise that he is opposed to any plan that would give healthcare consumers more direct choice. His argument is full of enough non sequitirs to fill a logic textbook.  To wit:

Here’s my question: How did it become normal, or for that matter even acceptable, to refer to medical patients as “consumers”?

Mmmmm…since doctors started getting paid? Though many things characterize the doctor-patient relationship aside from the money changing hands, the fact remains that money does change hands. Ergo, patients are consumers. Krugman implies that if they are not consumers, then health care choice should be handled by someone else–experts. Government experts. No, that does not make any sense, but it’s the best I can do with Krugman’s logic.

Next, we are told that “something must be done about costs.”

We have to do something about health care costs, which means that we have to find a way to start saying no. In particular, given continuing medical innovation, we can’t maintain a system in which Medicare essentially pays for anything a doctor recommends. And that’s especially true when that blank-check approach is combined with a system that gives doctors and hospitals — who aren’t saints — a strong financial incentive to engage in excessive care.

Bear with me on this one, because it took me a while to figure out Krugman’s point. The first sentence sheds some light on his collectivist inclinations. “We” must say no? How about “me?” I am forced to pay into Medicare and then we are concerned about costs. I’ll leave that one to the reader to dissect. The last sentence fails to note that an individual has no direct connection to the expenditure decision under Medicare and thus is in no position to rein in excessive costs. Individuals do not issue blank checks–governments do. Eliminate government from the equation and see how fast people manage “excessive” care.

Last, Krugman gets all ickified over that filthy stuff he studies in the abstract–money.

The idea that all this can be reduced to money — that doctors are just “providers” selling services to health care “consumers” — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values.

No, what has gone wrong with our values is the idea that individuals do not have the right to make their own decisions about medical care and everything else they consume (choice of words intentional). Inserting government into the equation distances patients from doctors and from the trade-offs that inevitably occur when we buy anything, including health care. People who pay for health care directly or who shop for health insurance in a truly competitive market will do a swell job of managing, thank you, Dr. Krugman.

About Terry Noel

I am an Associate Professor of Management and Quantitative Methods at Illinois State University. My specialty is entrepreneurship.
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2 Responses to Patients Are Not Consumers? Krugman Strikes Again

  1. Keith says:

    In the late 1970s, while attending paramedic school, we were taught patients were “patients.” However, sometime in the mid-1980s, I recall hearing patients referred to as “consumers” of healthcare. This was a time when emergency medical services were starting to branch out in their delivery of care to the under served populations.


  2. Deb S. says:

    I remember having a gyne-doc back in the day who thought he was the supreme ruler of his patients bodies. After his first mistake of NOT explaining to me that he was sending me off for a BIOPSY, he made the additional mistake of not offering me any options and informed me of how he intended to treat my “cervical growth”. After I asked directly about options, he informed me there were a few (didn’t name the options, just said a few existed) but his way was the best way. I asked for my file on my way out of the office and went to a new doctor. The new doctor was quite reasonable, was very comfortable explaining possibilities and procedures and allowed me to make my own decisions.

    There is a little something more to a doctor-patient relationship than pure consumerism, but the relationship starts there. I wouldn’t barter with persons I couldn’t trust.


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