There's something different, psychologically different, about health care. Debates about reforming the way we get medical treatment (and the ways we pay for it) can get a bit otherworldly (to my mind) if they try to pretend that this difference doesn't exist. Sheer economic and public policy reasoning just doesn't take some very important things into account.
Here's how I put it once: Imagine that if you wanted to buy a car, you were required to first visit a car consultant. This would be an expert who would eventually place your order with a car dealer, after first looking over your transportation needs, your financial status, and other factors. There would, of course, be a fee involved. But no one would be able to order a car on their own. Advertisements for cars would probably look similar to the ones we have today, except there would be a phrase at the end to "Ask your car consultant". Much more advertising and promotion, though, would be directed at the consultants themselves, as you'd figure. A steady stream of representatives from the various automakers would come by, extolling the virtues of the latest models and leaving stacks of glossy literature, DVDs, etc., along with offers of free trips to come by for some test-drives. Probably other incentives, too - there would be scandals involving payoffs to car consultants for steering their clients to various makes.
Practical Gastroenterology, A Peer Review Journal
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The Independent Review
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