Jeff Waggoner, M.D.

I practiced family medicine for 30 years in Aurora, Colorado. There finally came a time when I felt I could no longer give my patients the care they deserved. I left my practice and for 3 1/2 years studied health care policy and economics—trying to understand what had gone wrong with my profession. The result of that sabbatical was a book, MEDICAL METAMORPHOSIS—The three step cure for the American health care crisis.

One thing I discovered was that 30 seconds of discussion about health care policy will usually send people into a catatonic state. Still, I’d like to explain a bit of what I learned, so I’m going to spend the next three weeks spinning a tale about a mythical character named Harry. Perhaps his fable can be instructive without causing you to enter a coma.

HARRY’S FABLE—PART I

Once upon a time, there was a fellow named Harry. He was married and had a daughter named Harriett. (Harry and his wife were hardworking but slightly thin on imaginat ion.) One day, Harry decided that he needed a new truck. Actually, the sheriff decided Harry needed a new truck. He impounded Harry’s old one. It burned so much oil that on two different occasions a trip to the grocery store had brought out the local volunteer fire department.

Being a good consumer, Harry responded to this crisis by examining his family’s budget and then rigorously researching his purchase options. Harry was a rancher, and it had not rained for what seemed like 24 1/2 years. His options were rather limited. In fact, within a 3 county area, there was one truck Harry could afford—a 1990 Toyota with 185,000 miles on it that rested in a used car lot with a total of 3 vehicles in its inventory. The establishment was called “Golden Opportunity Truck and Auto Mega-mall.” Though thin on imagination, Harry thought that name was a stretch of reality.

Since he was a good consumer, Harry did not simply plunk down the truck’s purchase price. Though the loss of his old truck had forced him to use his brother-in-law’s to haul hay, check his cattle, and run errands, Harry did his best to negotiate a very best price for the 1990 Toyota. He left and came back 3 days running, pretending to be increasingly disinterested. He drove 90 miles to see a new brand of vehicle imported from China. When its fender fell off as he closed the passenger side door, Harry decided against the adventure of being the first in his county to own a truck made in China.

Time was not on Harry’s side. He was close to strangling his brother-in-law, Omar, because Omar was extracting payment for the use of his truck by making Harry listen to the same jokes—over and over. But Harry persevered. He was a good consumer.

Eventually, the power of supply and demand rewarded Harry’s persistence. Across the street from “Golden Opportunity Truck and Auto Mega-mall” was another used car lot, “Honest Bob’s Used Trucks, Cars, and Swing Sets.” It was the establishment’s involvement in swing sets that had made Harry doubt Honest Bob’s expertise, but when a 1993 fire-engine red 4x4 Chevy Silverado flatbed showed up on Honest Bob’s lot, Harry was willing to rethink his definition of expertise.

Harry was in love.

For 2 consecutive days, he had a cup of coffee with Honest Bob’s best salesman, a man named Robert. Their conversation was mostly one-sided. Robert talked and Harry stared at the truck. This did not go unnoticed by Buddy, the owner of Golden Opportunity. He furiously waxed and polished the oxidized surface of the 1990 Toyota all the while cursing Honest Bob—who in fact was one and the same as Robert. But even from across the street, Buddy could see the lust in Harry’s eyes for the fire-engine red flatbed.

Buddy consequently did something that hurt him deeply. He dropped the price on the Toyota, a vehicle he knew he could sell. In truth Buddy knew he could only sell it to Harry, and after two days of watching him gape at the Chevy, Buddy knew he had no choice.

When he received the call telling him that the 1990 Toyota could now be purchased for $500 less than its initial price, Harry was torn. The Toyota was now well within his budget. The Chevy was well outside his budget. But he was in love!

The issue was decided by one of Omar’s jokes involving a traveling salesman, 3 pigs, a rooster, and a far-sighted farmer’s daughter. Harry would need a loan to buy the Chevy. Getting it would be tough. Listening to his brother-in-law’s jokes while he tried to get the loan would be tougher.

Harry bought the Toyota with cash he had been squirreling away since the first episode with the volunteer fire department.

This is an example of the wisdom of the market. Budgets, life circumstances, and necessity all act in concert to create a rational decision. Harry bought a truck that was within his budget. It readily served his needs—hauling hay and running errands. Granted, Harry was not in love with the Toyota like he was with the Chevy, but life is not always about love. Sometimes it is about budgets and obligations. Sometimes it is about getting the best bang for one’s dollar.

Harry was a good consumer. He recognized these realities. His decision was a “rational economic decision.” Decisions like Harry’s are what make up “the wisdom of the market.”

The wisdom of the market is the stabilizing factor in a system of supply and demand. When the supply of trucks increased and competition ensued, the price of the Toyota eventually went down. Had Harry not waited, shopped, and tacitly expressed his opinion as a consumer by drooling over the Chevy like an adolescent male first viewing cleavage, he would have paid $500 more than he did for the Toyota.

Enlightened, empowered consumerism.

Next week—Part II, Harry becomes a medical consumer.

Dr. Waggoner is a family practice specialist with Weisbrod Hospital in Eads, Colo.