The national discussion about health care is undergoing the lobbyists’ metamorphism.  All during the Presidential campaign, the run-up to the inauguration, and the first months of President Obama’s administration, the focus was on universal health coverage.  But in the past two months, it has switched to making sure that private insurance is not undercut by a public program.  It is ironic that we are told to think of health care as a market good, but we are urged to not allow a competitor – the government – which most likely has a more efficient and better product.  We are not protecting the market in health care, we are protecting the cartels of the health care industry, from the for-profit insurance companies to the big corporate pharmaceutical companies, to health care providers themselves.

We won’t get to universal coverage coverage if we don’t challenge the status quo organization and delivery of health care.  After all, it is this status quo that has only diminished private coverage over the past twenty years.

But perhaps we need to step back even further in considering health care.  We’ve been getting into trouble ever since we started to consider it a “market” good.  It is not a commodity, like a flat screen TV.  You don’t choose to have Crohn’s disease, like my son, or breast cancer, like my colleague, or to just get old and start to fall apart, like my Dad.  Those are not market commodities.  People don’t consume broken arms, or colonoscopies, or skin cancer.  But once we consider people to be consumers of health care, and health care to be a commodity on the market, we have corrupted the moral dictums of the medical profession, in which the health of the patient should be the first consideration, and doctors consecrate their lives to the service of humanity.  The impulse for health care reform will fail if it centers around “show me the money”.