How did it become normal, or for that matter even acceptable, to refer to medical patients as ‘consumers’? The relationship between patient and doctor used to be considered something special, almost sacred. Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car.Krugman here taps into the antediluvian hostility toward bourgeois modes of providing for one’s self and one’s family. This ancient prejudice holds that ‘mere’ commerce might be acceptable to govern the production and distribution of trifles such as candy and cars, but it’s too crass for goods and services that tradition or elites declare should be untainted by such sordid, competitive activities.
If consumer choice isn’t the ultimate driver of health-care supply, however, what – or who – will be its ultimate driver? Health-care suppliers? Congress? Government bureaucrats? Princeton dons?