Free healthcare prevents financial exploitation

The argument

This argument identifies the problem with paid healthcare as an imbalance of knowledge rather than a shortage of money. It begins from a familiar case: if you know nothing about cars and you go to a mechanic for assistance, you are more likely to be ripped off. The reason is that you cannot evaluate the service you are being sold. You cannot tell whether the repair was necessary, whether it was done well, or whether the price is reasonable, so you have no choice but to accept the account given by the person who stands to profit from it. Healthcare is held to be the same relationship in a more acute form. Doctors study for many years to become experts in human anatomy and illness, and that expertise is precisely what a patient is seeking. It is unrealistic to expect the general public to acquire enough medical knowledge to protect themselves from financial exploitation, because doing so would mean replicating a training that takes many years. The asymmetry is therefore not a temporary gap that better information could close; it is permanent and structural, which means the public will always be at a disadvantage when care is bought and sold. The final step is about incentives rather than about character. Where a disadvantage of that kind exists and money changes hands across it, some people will inevitably exploit it for financial benefit — recommending treatment that is not needed, or charging what the patient cannot assess. The exploitation is a predictable product of the arrangement rather than an aberration within it. Removing the transaction removes the opportunity. Because free healthcare takes the financial relationship out of the consultation, and so prevents exploitation that patients cannot detect, healthcare should be free.

Context

Any business that involves a substantial knowledge gap between the consumer and the provider is vulnerable to exploitative practices. There is a substantial knowledge gap between doctors and patients in the medical profession. This leaves patients vulnerable to exploitation.

Premises

Counter-arguments

A free health system does not automatically protect against exploitation. The margin for exploitation remains, and potentially increases. Under a publicly funded health system, the doctor or medical professional can still bill the government for unnecessary treatments. The government will then pay for unnecessary treatment from tax revenue. This revenue comes from the public purse, and the financial costs fall on the population at-large. If the patient isn't paying for the treatment they are receiving out of pocket, they are likely to be less vigilant to unnecessary or duplicate treatments. Therefore, the margin for exploitation could increase.

Rejecting the premises

[Rejecting P3] Healthcare provided to patients free at the point of use does not necessarily remove profit from the industry.