🎧 Free Market Healthcare: Why the U.S. Pays Twice as Much
Anthony Teso
Editor’s note: Opinions expressed in this letter to the editor are those of the author alone and may not reflect the editorial position of ClarkCountyToday.com
Elizabeth New warns that public health financing leads to rationing, waitlists, and high taxes, and proposes a “free-market healthcare commission” as the antidote. But her argument rests on a comparison she never completes, and the missing numbers undermine her case.
Anthony Teso
The United States is already running the very experiment she fears. We are the most market-driven health system in the wealthy world, and in 2024 we spent an estimated $14,885 per person on healthcare — the highest of any comparable country. Switzerland, the next highest, spent $9,963. The average among wealthy OECD nations, excluding the United States, was $7,371 — roughly half what we pay. We are not paying more for more care. Studies consistently show Americans use many services at lower rates than peers, with shorter hospital stays. We simply pay higher prices for each one. Market competition, in other words, has had its chance here, and it has produced the most expensive system on earth without producing the best outcomes.
New also says that public systems ration care. They do allocate it — but so do we. The United States rations by price and insurance status, and we just decline to call it that. A family that skips a needed specialist due to a $6,000 deductible is denied care just as surely as anyone on a waitlist, only more quietly and without public accounting. Tens of millions remain uninsured or underinsured. That is rationing too; it simply happens at the kitchen table instead of in a policy document.
Her strongest rhetorical move is also her weakest. She quotes Whole Washington’s Kathryn Lewandowsky objecting that a partial plan would still force residents to buy private insurance for specialty care, then claims Lewandowsky accidentally endorsed the free market. She did no such thing. Complaining that people remain trapped with private insurers is an argument for expanding public coverage, not shrinking it. New inverts the meaning to score a point.
Underneath it all lies her real premise: that no one guards a patient’s health like the patient, so consumer choice will discipline prices, as it does for cars or groceries. Healthcare does not work that way. You cannot comparison-shop during a heart attack. You can only evaluate a treatment if you train to understand it, and you must address a diagnosis rather than discard it like an overpriced sofa. Economists have understood for decades that these features — urgency, information asymmetry, and inelastic demand — make healthcare a clear example of market failure. That is precisely why nearly every wealthy democracy treats health financing as a public responsibility and covers everyone while spending far less than we do.
New is correct that Washington should not trade one broken system for another. But the broken, expensive, rationed system is the one we already have. A commission devoted to deepening it is not a reform. It is a defense of the status quo, dressed up as choice.
Anthony P. Teso
Camas
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