The writer's explanation of what went wrong when California deregulated the
electricity market is not a good one. For electricity the problem was not
deficient rules or a bad new market structure. Electricity deregulation could
not work, rather than it didn't work. But Scarecrow got me thinking about the
analogy with the medical market.
Maybe everyone already knew this but it just occured to me that
medicine is analagous to labor intensive industries, like hair dressing. It is
a one-to-one experience, so for the basic hands-on work it is difficult to make
productivity gains. Of course productivity gains are not impossibe, just more
difficult than for, say, stock brokering, where a security analysis by one
individual can be sold to thousands without much extra expense than selling it
to one.
With medicine, doctors are sort of a priest or guild class, and with a
tight control over entry, wages have been kept high. For nurses, and more
generally nursing care, similarly a mostly one worker to one customer
experience, the cachet of a priest didn't keep pay up.
So, for those thinking deeper into the medical business than I am, what
is the model going forward? There is a demand for medical care that holds up,
especially when you want to keep yourself alive. And lots of technological
advances in drugs and electronics. But how to pay for nursing and doctoring?
Or is that becoming a shrinking part of total cost?
Gene Coyle
On Mar 18, 2010, at 7:38 PM, Louis Proyect wrote:
> http://seminal.firedoglake.com/diary/35854
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