Health Reform and Epidemic Disease


The CDC’s “Swine Flu and You” page offers the following under the heading of “what should I do if I get sick”:

If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

Of course as Igor Volsky points out:

But for the millions of Americans who can’t afford to purchase health insurance, a visit to a “health care provider” is an expensive proposition. We know that the 45.7 million Americans without insurance are less likely to visit a doctor and receive needed care, but the the economic crisis, the erosion of employer-based benefits and the skyrocketing costs of health insurance are now causing an increasing number of insured Americans to avoid their “health care provider.” According to the latest Kaiser Poll, 60 percent of Americans say that “they or a member of their household have delayed or skipped health care in the past year” and many are “substituting home remedies or over the counter drugs for doctors visits.”

Obviously, it’s not as if epidemics wouldn’t take place if we had comprehensive health care reform. But people being unable to go see their doctor for economic reasons doesn’t help; nor does the lack of sick days faced by many workers.

More broadly, the epidemic serves a reminder that the health care system is in many ways a public function. Free markets work very well for ordinary consumption goods, but Tamiflu is not an ordinary consumption good. It’s important to be able to direct the health care delivery system’s resources toward public purposes and not have the resources allocated purely by market demand.