The Wisdom of Bob Newhart, and Captain’s Quarters

via Captain’s Quarters, who’s been watching Bob Newhart DVD’s in the hospital while his wife recuperates from an apparently successful kidney transplant (best wishes to all).

The episode they’re watching has the professionals in their Medical Arts building setting up a co-op, with “disastrous results”:

….When a rational basis for regulating the demand for services is removed, the demand increases exponentially. Without that regulating force of money, the demand far outstrips the supply, creating shortages. It shows that money offers an objective control on demand so that the market can have flexibility in increasing supply and benefitting suppliers in a manner that barter simply cannot. Without it, there is no objective way in which to prioritize and ration access to services.

There’s a lesson in there for advocates of single-payor systems and nationalized health care, in which decisions on rationing get transferred to the government rather than the consumer or supplier. It’s not a direct analogy, but the episode certainly suggests an example for that as well.

Another spot-on observation.

Dr. Leap and the Money Quote

On money, medicine and anger at edwinleap.com
It’s very disappointing to have been blogging for several years and have so many ‘new’ bloggers (Dr. Leap, Panda, you) be so much better writers. Thank goodness I’m better looking (maybe).

Dr. Leap, well, leaps to the answer:

My friend, Dr. Carol Rivers, hit it on the head. People are happy to pay for what they want, just not what they need. It’s frustrating to have to pay a medical bill. But it’s less frustrating to buy a new truck, get a new lap-top, go to a concert, buy a pay-per-view sporting event. People in our society spend money like crazy on what they want. It’s just that health care is not what they want. They want health, like everyone, but a huge number of people consider paying a doctor or hospital bill unfair.

Unfair is something we need to address in medicine, in healthcare, and in policy discussions.

Many of my readers don’t want to know what I think of unfair as it applies to healthcare, and I’m cogitating how to explain myself.