Editor’s note: This piece first appeared on PandoDaily.com. It is being republished with permission.
First off — calm down, crazy Libertarians — I’m not suggesting we abolish either. But it’s certainly a problem that in both healthcare and public education there’s inherent confusion over who the customer actually is.
Think about how much the battle over public education doesn’t revolve around the students. The fact that teachers aren’t able to be fired for poor performance, for instance. That has to do with political officials allocating money and making rules, and basing those rules on what messages well to parents and the unions that support their campaigns. The kids themselves literally and figuratively don’t get a vote.
Healthcare is even more convoluted. We have a system where the doctors sell treatments to patients who don’t pay for them. For people with generous insurance, doctors are economically incentivized to order excess tests and treatments a patient doesn’t need, and the patients have no economic incentive to push back. For those with lousy insurance, they frequently can’t get the care they need, because the system is priced for a deep pocketing third party to pay steep medical fees that few individuals can absorb and avoid bankruptcy.