Ran across this and thought it might add something:
3. “The free market can resolve our problems in health care”
This myth continues to underpin pro-market health care policies of both major political parties, with the belief that the marketplace can effectively resolve access, cost, and quality problems in delivery of health care services. Touted as the “American way,” this view reflects the belief that a private, competitive market exists in health care. Yet there is incontrovertible evidence that health care markets do not behave in a freely competitive way. Robert Evans (38), health care economist at the University of British Columbia, has pointed out how market mechanisms in health care yield distributional advantages for particular groups, including providers, suppliers, insurers, and more affluent and healthier people. He calls attention to the natural alliance between providers, suppliers, and higher-income citizens in support of private financing of health care, leaving the burden of financing care for the sick and uninsured to the public sector. As a result, the farther such privatization goes, the more difficult it is to finance basic health care services for sick and lower-income people through a smaller risk pool.
It is well documented that the public interest is not well served by an unfettered private health care market, as reflected by these examples:
• An overriding goal of for-profit health care corporations is to maximize return on investment to shareholders; thus, even during our current recession, some for-profit hospital chains have reported profits of 45 percent or more (16).
• The extent of for-profit ownership of health care organizations is higher than many realize, including (in 1998) 85 percent of dialysis centers, 70 percent of nursing homes and home care agencies, and 64 percent of HMOs (39).
• Investor-owned health care organizations provide lower quality care than do nonprofit organizations (e.g., investor-owned HMOs scored worse in a 1999 study on all 14 quality indicators reported to the National Committee for Quality Assurance, such as 27 percent lower rate of eye examinations for patients with diabetes) (26).
• The overhead of investor-owned HMOs is 25 to 33 percent higher for some of the largest HMOs than for nonprofit HMOs (40).
• Market-oriented HMOs commonly use many strategies designed more to manage costs than to manage care (e.g., “deselection” (firing) of high- utilizing physicians, attempts to enroll healthier enrollees rather than sicker ones) (41).
http://www.pnhp.org/reader-old/Section 8 - Myth Busters/Myths as Barriers (Geyman).pdf
