Roy M. Poses has an excellent roundup of articles on the consequences of the “businessification” of medicine, at Health Care Renewal. As one who opposes both physician privilege and free-market healthcare, this adds an important dimension to the puzzle. Go browse.

Art Caplan and Glenn McGee have an excellent column on the heartbreaking absurdity of the very existence of the new “reality” show “Miracle Workers”. The premise is that, in a macabre and even more sensationalistic version of “Queen for a Day”, some desperately ill person will be chosen to receive free healthcare from a handpicked team of specialists at a major medical center. It’s hard to know where to start on how sad, how offensive, and how manipulative this is, but Caplan and McGee do a good job:

How can you tell when your nation’s health care system has collapsed?

One sure sign is the creation of a television program that offers access to health care to the desperately ill as a prize. . . .

In reality, a quarter of us have either no health insurance or lousy coverage. No one has a doctor who isn’t using much of the time once spent on patients talking to bureaucrats on the telephone to try and get approval for a prescription or a diagnostic test. A large number of us spend forever in emergency rooms to get basic care. There are many children who get no medical or dental care. The waiting times to see the doctor grow and grow. . . .

The strategy of the payers hired to look out for our health is to routinely turn down requests for reimbursement in the hopes that we will simply give up.

Oh, almost forgot, the cost of this pathetic mishmash of a bloated, inefficient and sometimes dangerous health care system continues to grow right alongside the numbers of people losing insurance coverage or benefits. That is the harsh reality.

What is really irritating about “Miracle Workers” is that the show makes health care seem a privilege, something you are lucky to get, rather than something you should have as a matter of right. . . .

Worse still, the show sends out the message minute after phony minute that there is hope. Well, if you have a lot of money there is. If you don’t, then this show is about as close as you are going to get to cutting-edge health care.

What “Miracle Workers” should make us do is shut off our televisions and sit down and write a letter or an e-mail to our congressional representatives and those who aspire to this office.

There’s more, and it’s better. Go read the whole thing. And write a letter.

UPDATE: Immediately after posting the above, I came across this item by William Saletan at Slate (cribbed from the Wall Street Journal): references to health insurance are cropping up more and more in online single’s ads as a prerequisite to a relationship.

1) A woman’s ad asks, “Do you make at least $75,000 a year and have health insurance?” 2) A man’s ad says he “can supply all the little things like health insurance and the big things like a nice place to live.” 3) Another man’s ad says, “If you are able to add someone to your health insurance as a ’spousal equivalent’ have I got a deal for you.”

As Saletan notes, both this and the TV show are the consequence of an inadequate and spotty healthcare system in which many people are without coverage; healthcare becomes a consumer good to be traded off against other desired goods. For those who have it it is a kind of economic status symbol, like a luxury car; for those who don’t, it is a point of economic leverage for others who can provide it in exchange for acquiescence in something undesirable (like a lousy job, or the invasion of your privacy on a tacky TV show). And those caught in this grinding, perverse system are simply grateful for any reprieve they can get: through their employer, who depresses wages to offset health benefits; through a spouse with dependent coverage under the same terms; or through a degrading TV display of their needs and hopes.

(Hat tips: Ezra Klein and HealthLawProf Blog; original article from Wall Street Journal.)