If you haven’t guessed it yet, I am talking about Doctors. This might seem like not the right time for this, with everything going on with "You know what". People are, now more than ever, seeing doctors as gods. But I am more rational than I am emotional. This article is more like an extension of my previous article. But you might think about what connects socialism and the Medical sector. In fact, a LOT, and not in a good sense. The connection is not so much with socialism as much as with the points I discussed as the core reasons behinds the inevitable failure of socialism. I will list that again here.
1) Absence of Skin in the game
2) The Self-interest problem
3) The competition problem
These three reasons are behind the failure of socialism. But in the medical sector, it has completely different effects. It practically creates capitalism in a socialist-ish market, and it is always ugly. Let me elaborate a bit more
First, we have to understand why the medical field is a socialist-ish market. By saying socialist, I don’t mean centralized planning and government control here. I am talking about all the worst features of socialism. This is where the three points come in.
Absence of skin in the game
(Absence of personal risk when the outcome is a failure)
This might be controversial, but I have no reservations in saying that the field of medicine has no skin in the game, especially the doctors. I mean, think about it, for argument’s sake, you are undergoing a critical surgery, what the doctor got to lose if he/she makes a mistake and inadvertently kills you. Honestly, the case will be closed by saying that it was an act of God, and they couldn’t do anything.
These are the same people who killed one in three children at birth because they didn’t believe in germ theory until the 1920s, and who thought bloodletting (Draining body of a few liters of blood) will cure any disease until the nineteenth century. As I have said multiple times in many of my previous articles, there is nothing called altruism. Why should doctors be expected to behave that way?
The Self-interest problem
(Difference in self-interest for both parties involved)
If you have watched any movie in which a doctor is portrayed negatively, then this is what it is implying. Your self-interest here is to get rid of your disease, and the doctor’s self-interest is to make a buck.
The competition problem
(Absence of a competitive market)
This is the major separator between Medicine and almost all other capitalist sectors. This is not a business where you lose “business” because you are high-priced or have a poor track record; probably no one will ever get to know a doctor’s track record. If the doctor is charismatic and the people there seem to be nice, you got a “customer” (patient) for life. This is why the medical field is socialist-ish.
This problem accentuates the previous two issues. Think about this, what prevents a Business from cashing in in a non-competitive market where you have any financial risk in an event of trouble. Please don’t say ethics… That’s not how it works. Economics runs the world, not values and morals.
You want proof for it, go and search for the number of unnecessary deaths happening every year due to medical and prescription errors; one small hint, it is much higher than deaths due to road accidents. And that will be just the reported deaths. The stigma of a medical error will probably hide a lot of deaths, so the figure you see is practically non-representative.
There is another capitalist sector that is responsible for millions of lives every year, but the attitude difference to failures is as disparate as night and day. And honestly, it is capitalism at its best. If you haven’t guessed already, it the airline business. But it is also down to the three points which I have been discussing.
Airlines have everything to lose in event of a failure. For one thing, the pilot goes down with the plane – which costs millions of dollars - along with the share prices of the Airlines and the Aircraft manufacturer. So, you get the point. Unlike doctors, pilots have everything to lose when failure happens.
The self-interests of both parties involved have never been more aligned as in the airline field. You, the pilot, and the airlines have a deep self-interest in taking you from point A to point B safely and on time.
And Airlines are easily among the most cut-throat business there is. There is no reason for customer loyalty and in event of a failure, your company is royally “FU*KED*. Take Boeing as an example.
The thing you need to observe here is that I am not claiming Pilots are good people and Doctors are evil. I am talking about economics and psychology here. And just because someone is acting for his self-interest, he/she is not evil; Is the Pilot evil because his self-interest is to reach home safely. It is a psychological issue; you cannot help it. It the nature of the medical field.
In the title, I mentioned unwarranted reverence, and I don’t mean any disrespect here. What I meant to say is that this undue respect creates a layer of invulnerability to that profession which makes matters much worse.
A capitalist sector that is working in a socialist-ish market is the root of all evil here. The only way out of this is by taking capitalism out of the socialist-ish market; meaning, to make the medical sector socialist. There is never a technological or scientific advancement in the medical field which arises out of completion; not the pharma industry, where advancements occur almost exclusively out of the competition. Medicine, as a field, has always advanced as a result of academic research making this an ideal candidate for centralization. This is what they have done in Europe and it seems to work.
The nature of the medical field makes it impossible to incorporate the first two points (skin in the game and the self-interest alignment) into the field; you cannot behead a doctor who committed a medical error. But taking capitalism out of medicine will at least make the sector more just, and perhaps more ethical. The medical field, in its current form, takes the worst things from capitalism and socialism, and it is a bad combination. I believe capitalism must be taken out of this field. Because no one, except the medical industry, is gaining anything from the sector being a capitalist. Capitalism should not work like that. The benefits of any transaction must be ideally equal for all parties involved.
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