Without getting into an overly complicated, Marxist debate about the nature of a commodity, the answer to this question is relatively simple: yes/no. We spend money on healthcare; businesses profit from our spending. So, yes, healthcare is a commodity. On the other hand, it’s next to impossible to affix a value to extending someone’s life, relieving their pain, helping them function. At the center of the debate, there exists a disconnect between what healthcare costs (equipment, expertise, drugs, facilities) and what it’s worth. So, no, healthcare is not a pure commodity.
According to the NCHC, in 2007, health care spending in the United States reached $2.3 trillion. That’s $7,600 per person. We spend roughly 16 percent of our GDP on healthcare. Other notables, Swizterland, Germany, and Canada spend 10 percent or less, and somehow we manage to leave almost 47 million Americans uninsured. This is what healthcare looks like when it is treated inappropriately as a true commodity. Inflated costs, incredible waste, and the best possible doctors/procedures for the privileged few that can afford it.
The neo-capitalist would call this a success. “We have the best doctors and the best equipment in the world,” they would say. This kind of sentiment has been the measure of healthcare in recent memory. And it is a fundamental failure as it never takes into account accessibility or affordability of healthcare as a service. It is a broken system. Easy to criticize, I know, but I’m about to offer a solution.
It hinges on analyzing two aspects of the nature of healthcare: human need/right and commoditization.
First, healthcare is a basic human need, but can we call it a right? And second, to what extent is healthcare a commodity?
The simple answer is that healthcare is a right to the extent that we can afford it, and it’s a commodity to extent that we can’t. This means treating healthcare as such. We begin by setting up a tiered system for healthcare. The first tier is preventative care, simple procedures, general doctors vists, etc. In this scheme the government subsidizes the entire first tier. Not only does this limit what private providers have to cover, it ensures access to preventative medicine for every American reducing the overall strain on the system. Second and third tier (expensive, elective, and experimental procedures) can then be parsed out among private insurance companies dramatically reducing insurance premiums.
What remains is a not-insignificant-debate over what fits into the tiers and how to rebuild the existing infrastructure to accommodate the expansion of preventative care. By tiering our healthcare system we can begin to treat the citizens of the United States ethically and responsibly. It’s the first step of a long journey to realize the potential of the American dream.