Clear Answers: The Economics and Politics of For-Profit Medicine

Marilyn Mardiros is an associate professor of health sciences at the
University of Ottawa.

Clear Answers provides a brief summary of facts and figures about
Canadian health-care reform today. The authors discuss for-profit and
not-for-profit public health-care services and market failure (i.e., the
failure of the market to produce and distribute health care effectively
and efficiently).

Using examples from Alberta and the United States, Taft and Steward
demonstrate that for-profit competition increases costs and
administrative inefficiencies, creates barriers to equal access to
services, and has the potential to threaten the quality of care. Market
forces do not work with health-care products as they do with products
such as food and consumer goods. Viewed from a consumer perspective,
patients are deprived of the opportunity to comparison shop because they
do not have the expertise to evaluate health-care products and services.
Similarly, they lack the qualifications needed to evaluate the specific
service received (e.g., the appropriateness, interpretation, and
subsequent implications of lab tests).

The authors conclude that misguided government policy, not medicare per
se, is responsible for eroding public health care and increasing the
role of for-profit medicine. Their book raises many more questions than
it answers, but it succeeds in making the reader a more informed, and
critical, consumer of health-care services in Canada.