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ABSTRACT
This essay argues for two conclusions. First, clinical decision-making is not best thought of as analogous to the purchase of other services, such as car repair. Health-care decision-making is far more difficult, collaborative, emotionally fraught, and subject to cognitive distortions. Second, the provision of health care should not be delegated to unregulated markets. Unlike other markets, there is no reason to expect health-care market outcomes to be efficient or fair or to promote individual freedom, properly conceived. Markets may play an important role in implementing an allocation of healthcare, but they are not an ethically acceptable alternative to determining what that allocation should be.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes
1 David Eddy, quoted in Groopman (Citation2008, 151).
2 Although patients experiencing Covid-19 can refuse a genuinely efficacious treatment, such as paxlovid, they cannot insist that providers prescribe an inefficacious and potentially harmful treatment, such as ivermectin, or bleach.
3 “’Fix-it’ language also creates unrealistic expectations about the patient’s postoperative return to normalcy and confounds the difference between the technical aspects of what can be done and whether it will benefit the patient” (Stalter et al. Citation2023).
4 See The National Health Care Institute, “The Dutch Health Care System.” https://english.zorginstituutnederland.nl/about-us/healthcare-in-the-netherlands accessed December 17, 2020 and the document, “Health Care in the Netherlands” available at https://english.zorginstituutnederland.nl/about-us/publications/publications/2016/01/31/healthcare-in-the-netherlands.