In a much discussed and very provocative essay about health care, Atul Gawande makes two very compelling arguments.
First, that doctors and hospitals don’t share enough information and are thus very inefficient. This claim should not be controversial. Whenever humans have shared information the outcome has been greater life, liberty and happiness. The second observation, however, gets at a fundamental point of contention in American society: does the profit motive ensure the greatest efficiency in every kind of transaction?
Gawande answers “no,” pointing out how revenue-driven heath-care leads doctors and patients alike to engage in transactions that, while profitable for the doctors, do not lead to better health outcomes for the patients. The wealthier the doctor does not necessarily mean the healthier his or her patients.
If you believe Max Weber had us modern Americans pegged when he said we confuse the size of our bank accounts with the brightness of our halos (or, that the wealthy have values the poor lack) the origins of this mistake are clear-cut. What to do about that confusion is not as clear. There is certainly a humanistic counterpoint to the Protestant work ethic in American culture. From a theological perspective, “all men are created equal” is quite the claim. But it is only in fits and starts that we affirm concern for our fellow man as the goal of our founding compact – and caritas a defining characteristic of a more perfect union.
Doctors are more fundamental to our democracy than we realize. If each man has an inalienable right to life, what of the life sciences?
We may already have a precedent in our justice system. Private lawyers can make wildly varying incomes. But are the most just judges, the best paid? We don’t appear to think that way. And that might be a good place to start thinking.