The Market for Peformance Enhancement

In yesterday's New York Times, bioethicist Carl Elliott suggests that the public has been too quick to condemn baseball players for taking steroids, given how eagerly Americans use all manner of performance-enhancing drugs. Fair enough. As I've said, I really don't understand the fuss about steroids, provided everyone plays by the same rules.

But then Elliott adds, "Perhaps this is the inevitable result of turning our medical system over to the market, where making sick people well is often less profitable than making well people better than well." He talks about letting people buy and sell health products and services as if it were some radical policy experiment, a strange way to look at it, especially since "our medical system" has never been fully socialized. And he does not pause to consider why it is that the areas of health care that are most socialized, most dominated by third-party coverage, and most subject to bureaucratic control—the ones that involve "making sick people well," as opposed to "making well people better than well"—are also the most dysfunctional.