In his column this morning Nicholas Kristof’s muses about what it would be like if newspapers were more like the healthcare system. It reveals that Mr. Kristof, despite his years in the newspaper business and his years covering healthcare, doesn’t understand either the newspaper business or the healthcare system.
Yes, newspapers would be cumbersome and inefficient if they operated the way the healthcare system does. What Mr. Kristof misses is that under such a system he would be a quack and could be thrown into prison for practicing journalism without a license.
It wouldn’t matter that he’s smart, as Mr. Kristof certainly is. It wouldn’t matter that he went to the right school, as Mr. Kristof certainly did.
Mr. Kristof went to law school not journalism school. Without the degree, without certification, without licensing, however knowledge or capable he might be, his practicing journalism would be a crime and he would be subject to arrest and criminal prosecution.
The reasons that journalism as it as been practiced for the last century is dying include that newspapers have been unable to prevent their business model from being eroded by sites like EBay and Craig’s List, that blogs have made it patently obvious that there are thousands of people fully capable of doing what a handful of newspaper columnists used to do, and because newspapers have systematically abandoned the nuts and bolts reporting, much of it very poorly compensated, that used to be the backbone of their content.
In my view a much more interesting column could have been devoted to what medicine would be like if it were more like journalism: unscientific, unsystematic, unlicensed, unsubsidized. I don’t think it would be a pretty picture but it would certainly be illuminating.
Sure, we should just let anyone who wants practice medicine and let the markets sort it out. I have a difficult crani for tumor scheduled tomorrow morning. If anyone wants to take a crack at it, let me know.
In case it isn’t clear, Steve, I am not advocating that nor have I ever.
Milton Friedman famously promoted killing off medical licensing restrictions. You should deal with his argument instead of your strawmen.
Similarities between newspapers and medical care:
Both are best in big cities, awful in the hinterlands.
Big differences: In newspapers, you buy a bundled product. If you never read the Sports Section, you pay for it anyway. Medicine is not (yet) like that, unless you finance it through insurance by which a single man is paying for perinatal care of women, some of whom he hasn’t slept with.
You can find out the price of a newspaper by looking right at the front page. All prices and costs in medicine are very well hidden.
Medicine suffers from cross-subsidies in which the poor and uninsured pay, through taxes, for the medical care of the middle class, for only one example. Rich folks have to pay for their own newspapers.
Newspapers can use ink and paper that haven’t been subject to strict government controls. If they don’t like what US producers offer, they can buy from Canada and Mexico. And if Americans won’t buy them at their prices, they have domestic and international alternatives.
Medicine is rigged so that you can only use government approved drugs and devices and cannot freely import them from other countries. You cannot use your Medicare, Medicaid, SCHIP or standard insurance overseas in your quest for better prices or products.
Ok, sorry Dave, but you certainly hint around at something like it sometimes. You advocate for increased supply, but are not clear on how to do that. You suggest that Mr. Kristof has all the qualifications to be a journalist, but has no “license”. There is nothing magical about a license. If I dont renew my license this year I wont suddenly become less competent. It is really just a signal that you have completed all the necessary qualifications, and that you agree to abide by state rules. It also means that they have been monitored during their practice. If we did not have licenses, we would have something else just like it. We need some way to determine if people are capable other than letting them work and see if their patients survive. We need some way to track people.
I didn’t say he had the qualifications to be a journalist, Steve. I said that he’s smart and went to a good school. In this hypothetical world he would have needed to get a journalism degree from an accredited journalism school, something he has not done, and on top of that he would have needed to be licensed.
I don’t think that lawyers are ipso facto qualified to be doctors or vice versa.