On the Third Hand: Barter

Bartering for health care has a long, honorable history.

Robert Heinlein wrote in some of his books about his grandfather, Dr. Alva Lyle, an old-time physician who collected many of his fees in the form of fresh chicken eggs.

I have personally met a medical biller who reported that she has worked for a physician in Queens who gets much of his compensation in the form of Middle Eastern cookery.

Of course, success at getting health care through a formal barter exchange may depend on factors such as how effective an exchange is at signing high-quality, convenient health care providers. People developed money in the first place because having money that you could can spend on any product or service that you desire tends to be simpler than having to use “exchange dollars” to buy the same products or services from other exchange members.

But barter can be a good way for getting the invisible hands of supply and demand to meet when suppliers think the value of what they’re supplying is much higher than what the buyers can afford to pay.

In today’s deflationary environment, barter may play a different role: Helping barter exchange members conserve scarce, previous cash.

“People are terrified of paying cash out of their pocket,” Graham said.

On the one hand: It’s a lot easier for me to brainstorm about this than it is for anyone out there to actually try this (and to get blessings from all of the regulators, accountants and lawyers who ought to be consulted).

On the other hand: If you, through your work as a health insurance broker, plan administrator and chamber of commerce member actually know a lot of underemployed health care professionals, other professionals and merchants with excess merchandise, maybe it would be fun to work with a well-run barter exchange to add a well-promoted health care services component, just to see what would happen. Maybe, for example, concierge service package barter could be a way for doctors to avoid feeling the effects of any Patient Protection and Affordable Care Act (PPACA) physician reimbursement storms while protecting member employer employees from having to wait 10 hours in a physician’s waiting room for a checkup. 

On the third hand, a well-run, well-promoted health care services barter program could be a blow to someone’s ego. Maybe, trade exchange members will find that traditional acupuncturists actually have a higher barter value than the services of physicians who’ve gone through 24 years of brutal residency training, or that, sadly, all of the curios in a cute little antique shop really aren’t worth one simple dental implant.

See also:

• On the Third Hand: The cat
• On the Third Hand: Crazies
• On the Third Hand: Data