"Leavitt’s Dystopian Vision"
I feel like David Broder needs to think harder about this:
What I learned about Leavitt in his years as governor is that he is blessed with vision that sees future policy challenges and developments more clearly than most politicians. In this case, he is visualizing a radically different kind of medical marketplace, in which families armed with specific information about the treatment success and prices of hospitals and doctors can shop at will for the best quality and most affordable care.
Maybe there’s some situation in which this would be a good thing, but mostly it sounds terrible.
By contrast, here’s an anecdote. Some time ago, I noticed that the sole of my foot was incredibly painful to walk on. I took off my shoe and sock and saw some kind of weird grossness bumpy thing down there and could tell that that was the epicenter of the pain. I called my doctor’s office describing the problem as best I could and asked for an appointment. I got one about two days in the future (waiting times! even in America!) and hobbled around until then. I went into the office, the doctor looked at my foot, immediately diagnosed it as an abscess and did some incision and drainage and then — bam! — it was done. That involved poking me with a sharp object, which seemed like it would be an unpleasant experience, but I trusted that it was the right way to go because he’s a doctor and I came to his office to be told what to do with my foot not to do independent research, ask around, start haggling, second-guess everyone, and generally remain in pain while I tried to sort things out according to Magical Market Medicine.
People want to live in a world where, when you have a medical problem, you locate a doctor and that doctor either does what needs doing, or else points you to an appropriate specialist doctor who does what needs doing. Shopping around for gadgets or browsing bookstores is fun for those of us who are into them; others like clothes-shopping or shoes. But nobody wants to shop around for medical treatment. That sucks. Sick people want treatment.