10/22/2012 10:13 am ET Updated Dec 18, 2012

The Monetization of Health Care

The problem with the health care system is that it participates in free market economics. With or without Obamacare, the same condition prevails, and many of the problems that insurance companies and providers do, in fact, face and pass down to patients are the result of ways in which medicine and health care are plugged into the vicissitudes of supply and demand.

Thus, some life-saving cancer medications are out of the reach of those who need them because there are not enough of these patients to provide the economy of scale that would bring down the prices. Insurance companies who refuse coverage are only reflecting a reality. Of course there are certain drugs that have enormous followings and are so prized that manufacturers are able to charge exorbitant prices that in turn produce windfall profits.

Cialis is one of these, and one wonders if there isn't a touch of old Salem not only in the extraordinary sums that are demanded for the pleasures of having an erection, but in the fact insurers have not been successfully challenged in their refusal to reimburse those of their constituents who use the drug. Of course, the attempts by the Republican candidate for president to deny coverage for birth control (and in fact to disenfranchise Planned Parenthood) represent a similarly-punitive attitude toward sexuality. But what about the right to life for those who can't afford or aren't covered for dialysis (which is what could happen if Obamacare is repealed)? People are aghast when they read about the black market in human organs and see a movie like Steven Frears's Dirty Pretty Things, but isn't this seemingly-hyperbolic example of human greed a metaphor for what happens when the caduceus is turned into a dollar sign?