At his Skyped-in speech to a group of health care reform advocates earlier this week, Republican state attorney general (and gubernatorial candidate) Rob McKenna, who sued the federal government to overturn the mandate that all Americans get health insurance, made a point that seemed at odds with his "competitive marketplace" approach to health care, which casts doctors as salespeople, patients as consumers, and health care as a product.

Between arguing that patients should get financial incentives (for example, a high-deductible plan with a limited amount of money deposited in a "health savings account") to use fewer health-care benefits and saying we won't have a national health care system until "the [Geico Insurance] gecko on TV [is] selling us health insurance, McKenna (who's suing to overturn the part of the health care law that requires all Americans to get health care on the grounds that it forces consumers to buy a product) made this out-of-synch argument against standalone "urgent care centers"---private emergency clinics that may or may not be affiliated with a hospital:

We see overexpenditures in some cases. We have an awful lot of urgent care centers being opened all over the landscape. How many of these mini-ER departments do we actually need? Because it seems to me that when you build it it, will be used, whether it's a hospital bed, an ER department, an MRI machine, or what have you.

But wait a minute. If McKenna is in favor of letting the "market" for health care work things out, why does he object when the market creates urgent health care centers (and does he support government intervention to shut them down)?

No meddling government agency is forcing companies to build urgent care centers; they're building them because they can make money doing so (largely from patients who pay cash instead of charging their insurance, in exchange for a substantial discount). In McKenna's market analogy, the proliferation of private urgent care centers should be value neutral. Instead, he sees it as encouragement for people to thoughtlessly use too many health care services.

McKenna's campaign spokesman, Randy Pepple, has not yet returned a call seeking clarification of McKenna's position on urgent care centers.