Wednesday, October 3, 2012 | 5 comments

Free-Market Healthcare Solutions Are Already in Place

By Riley Risto

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When I first read this story of a volunteer medical/dental clinic in St. George, I was not as awestruck as others might be. A community of volunteer professional healthcare providers coming together to serve those in need is certainly praiseworthy, but is it rare?  These clinics are in every major city in America. Many smaller communities have them as well. The National Association of Free Clinics (NAFC) puts the number of these clinics at 1,200 nationwide.  There are probably many more that don’t belong to the NAFC or have a slightly different funding or deployment model but still help underserved populations, such as the local cash clinic in my community. So, what makes The Doctors’ Volunteer Clinic of St. George unique?  Perhaps Anthony Young, general counsel to the NAFC, said it best:

“It is a rare community [which] demonstrates responsibility for the improvement of their community’s health in such a manner as The Doctors’ Volunteer Clinic of St. George, without seeking government funding…

Indeed it is!  As a people we’ve become accustomed to “charity” being just another function of government, and a legitimate purpose to impose taxes upon individuals. When we see suffering, many shirk any personal responsibility by assuming that there is a government program to take care of it. Of course, government does not have a face to smile back at when care is provided pro bono. It does not have ears to hear a patient’s heartfelt appreciation for compassionate service rendered. Most importantly, government does not sacrifice any time away from family or recreational pursuits to unselfishly care for another human being. Obliterating this link between the giver and the receiver of service has been the great crime and byproduct of state intervention.

Well, someone forgot to tell the folks at this clinic and their private corporate benefactors that there’s a trough of pork barrel funded slop available if they are willing to give up the spiritual and psychological benefits of honest, charitable service.  Or maybe they simply choose to take payment in hugs and smiles over mammon.

This last point should not be overlooked.  Most employers will testify that employees work for a variety of remunerative benefits, not the least of which are psychological. When asked why the professionals at DVC volunteer, Dr. Paul Doxey, chairman of the board, offered the following reasons:

  • It’s medicine as it should be practiced
  • Patients are universally appreciative
  • Good feeling at the clinic
  • Being able to treat the patient rather than worrying about protecting yourself from liability
  • Satisfaction at the end of the day

How many health care professionals would trade a small portion of their incomes or leisure time for the satisfaction of joyfully practicing their craft without worrying about malpractice lawsuits or  insurance collection? Apparently enough of them to staff at least 1,200 clinics throughout the USA.  The DVC has a part-time, volunteer staff of dozens of professionals which further leads us to ask: if there are tens of thousands of doctors nationwide willing to give time and talent to help others, and myriad private, for-profit corporations willing to sponsor such activities at no small expense, why do we need government in the healthcare business at all? Could it be possible for a system of spontaneous organization, motivated by nothing more than a desire for “good feelings,” to replace the top heavy, wasteful, bureaucratic nightmare that is nationalized health care administration?  The DVC has certainly moved the needle in that direction by tackling the need for basic and preventative services in their community. They can and should serve as a model to replicate elsewhere.

We would not call for the immediate dissolution of health care benefits provided by the state.  Far too many (veterans, elderly, unemployed, illegal immigrants) have become acclimated to and dependent upon such an arrangement and would suffer immediately and significantly as a result.  However, we believe many more communities could benefit from a proactive, personal, and private response to local needs. An infrastructure founded upon personal responsibility, charity, choice in healthcare, and unhindered pursuit of monetary and non-monetary benefits needs to arise preemptively before a doleful electorate will accept the truth of free market superiority in health care.

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About the Author

Riley Risto is Director of the Center for Free Enterprise. He holds a masters in business from Brigham Young University and works as a community banker. He is a passionate advocate of Austrian economics, outdoor enthusiast, husband and father of six children. He lives with his family in Midway, Utah.

Riley Risto
Riley Risto

Thanks for reading and I appreciate your comments.  I thought it was fairly obvious that this article was highlighting a piece of the overall solution to the healthcare fiasco, that of providing for the poor and needy, which is the emotional bait always used by liberals to justify state intervention in healthcare.  If this problem is solved through a model which has been replicated and is scalable to any size and scope, given removal of disincentives, wouldn't that in turn take ammo away from the argument for nationalized healthcare?  Wouldn't the debate then turn towards making the system more efficient for the middle class by reinstituting private responsibility for personal healthcare costs?  It seems to me that if you neutralize the argument for healthcare welfare by demonstrating free market provision for the most vulnerable, that we can finally move away from our one-size-fits-all approach. 


I think your comments about shifted responsibility are spot on.  The cause of increased costs is an increase in demand for services caused by government mandated coverage levels, elimination of lifetime maximums, government as backstop for non-paying patients, etc.  It's very similar to the problem with tuition increases that result from government funding of student loans.  If a college education becomes a human right, it's a no-brainer that college tuition will increase because responsibility for payment of tuition has been shifted sideways to the ultimate loan guarantor (Uncle Sam)...basic supply and demand.  Same holds for healthcare.  Shifted sideways to the employer and insurer (private or public).




I'm not sure the title and the content match. What you are discussing is a minuscule piece of the healthcare fiasco. The problem is that there is no market at all. Of the 16.6% GDP spent on healthcare, about a third if that is gov't subsidized, which means shifted to future generations as a tax. Employers also pay a significant amount. With that much pain shifted away from sick people, they make inferior decisions. Example: with a $10,000 deductible, I took my daughter in to the pediatrician. She had a back ache that had lasted about two weeks. The doctor said, "well, we can do an x-ray and an ultrasound." "Which one?" I asked. He said that we would do both. When I balked, he said, "your insurance will cover both." I told him that it would not and that I wanted to know which would be more likely to be revealing. I wanted to do one first and then the other if the first showed nothing. When I felt the full pain of the healthcare cost, I made a better decision than the doctor was about to make for me.

The problem is that the government, businesses and insurance companies either shift pain or hide it. Markets require pain to become efficient. Until pain (mostly financial) is reinstated at the consumer level, people will not demand (economically) more efficient solutions and we will continue to shell out 16.6% of GDP instead of the 5+% we used to shell out in the 1960's.