I am not, by the way, the first person to make an argument for consumer-driven health care by using Wal-Mart as an example. David Goldhill, a media executive (and self-described Democrat) who wrote, “How American Health Care Killed My Father” for the September 2009 Atlantic, made the comparison in an NPR podcast last summer. Here’s how he put it:
You benefit from Wal-Mart whether you shop there or not.
In most goods and services there are very few active consumers. What happens is, everybody selling a good is affected by Wal-Mart. You benefit from that wherever you are. So many of those who oppose consumer-driven health care use the perfect as the enemy of the good. You’re not going to shop for health care if you’re hit by a bus. That’s not the point. The point is you’re served in a health-care system that’s been tightened up, both from a cost and quality point of view, by the fact that some consumers, for many procedures, are shopping around, and not just on price.
The reality is that if I’d known what I know about this hospital, it’s not where I would have put my father. It’s not that I would have been able to discover that when he got sick. It’s that in the same way that I can find out about almost any business that I choose, their quality record and their pricing, I want the same thing for health care. It doesn’t mean that if you’re hit by a bus you pick up the phone and call ten hospitals.
And I think this misunderstanding of how consumer economies actually work is crucial to a mistake that’s made a lot, which is that it’s much better to have some big, financially interested institution make a decision on your behalf because you’re not smart enough. You don’t have to be smart enough to get the best deal on most things in our economy, because some people care enough to create the Wal-Marts of the world. And that’s all that happens, is that once there’s a Wal-Mart, you’d better be competitive with Wal-Mart, or you’re out of business.