For the last several years my warnings about the consequence of marketplace practices and the lessons from the US health system have had to confront claims that we were different, that these things could not happen here or that our regulations would stop similar things from happening. Marketplace advocates have argued that what they are proposing is not the US system. I have had to make the point that in the real world we live in a corporate marketplace in health care cannot escape the same pressures that have dominated the US system and US corporations are likely to take control. Samuel's model is no different.
CLICK HERE -- to go to an examination of the evidence and a discussion of this issue
Samuel justifies his marketplace solutions for health care by referring to very different commercial activities. There is already a health care marketplace and a vast experience. This is what the arguments must be based on and this speech does not do so. It chooses to largely ignore this experience - an experience that seriously challenges the solutions promoted and suggests that this model poses a serious threat to the welfare of citizens.
Samuel's marketplace arguments are as illogical as those promoted by the representatives of for profit corporations (eg. Tenet/NME's John Bedrosian) over the last 20 years. The response to criticism of the marketplace in Australia is similar to the response to Professor Arnold Relman's criticisms over the same period. Relman has been vindicated by events but true believers in the USA are still blind to this.
CLICK HERE -- to go to a page which explores these arguments.
My criticism of this speech is an attempt to confront Samuel's ideas with recent events in the health and aged care "marketplace" and direct the spotlight of logic and common sense. The thinking exhibited by Tenet/NME, Columbia/HCA and Sun Healthcare and the conduct which resulted illustrates the way in which the market and market theory has pursued its own internal logic, disregarded alternate arguments and ignored unpleasant facts. It has used the power and credibility obtained by success on Wall Street to impose its solutions and its thinking on society. In criticising I will use the conduct and the thinking of Tenet/NME and a number of other large corporate groups to explore marketplace thinking and practices. I will use the insights gained as a framework for understanding and criticising Samuel's speech. I will also use them as a framework for suggesting ways in which the problems facing health care might be more appropriately met.
CLICK HERE -- to go to the criticism of the next section of Samuel's speech
CLICK HERE -- to go to the next section of Samuel's speech