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Published at www.nejm.org November 11, 2009 (10.1056/NEJMopv0909194)

Looking beyond the Market

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For the most part, the market doesn't work where health care is concerned. It has been particularly ineffective in constraining costs over the past half-century, with stakeholders (insurance companies, organized medicine, pharmaceutical companies, trial lawyers) propelling runaway spending. Yet as they shape reform legislation, politicians on both sides of the aisle merely want to make relatively minor adjustments to the current system.

The market is about maximizing profit, and it encourages predatory behavior by participants who have an advantage, as the stakeholders in the health care system do. Because of the asymmetry of knowledge between providers and consumers, if doctors . . . [Full Text of this Article]




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