Tuesday, June 07, 2011

Brooks and Economics of Healthcare

One of the things I miss in the current chattering classes commentary is a focus on market structure.  The questions of monopoly and pricing power don't play much of a role in current debates.  For me, I remember the strain surrounding the receipt of the monthly (I think) milk check and egg check.  We'd shipped off our milk and eggs, consigned my parents' work to the fates, and waited to see what we'd receive in return.  Open the envelope and see the check amount: maybe it's up, maybe down.  The closest parallel I can come to in today's life is the arrival of the bills for electricity and water/sewage.

In both cases, the person has no pricing power; they're at the mercy of the market structure.  

David Brooks has a piece  on healthcare saying Democrats believe in the power of government experts to cut costs, Republicans believe in the power of competition and consumer choice.  I'd say that misses the fact that government, as purchasing agent for consumers, can have pricing power; consumers in the context of the healthcare market don't.

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