Re: Gov't loves Gov't

Charlie Stross (
Wed, 21 Jan 1998 15:47:04 +0000

On Wed, Jan 21, 1998 at 02:40:15PM +0000, Mark Grant wrote:
> Charlie, I think you need to clarify your argument. You seem to be
> saying that diabetics can't get cheap health insurance, whereas a
> government funded system would cover them. Yet you then say that thanks
> to the NHS there's no free health insurance market, and that untreated
> diabetes is a major cause of road accidents, implying that the NHS is
> doing a lousy job of treating them.

Eh?!? You're attributing causal relationships between the things I was
talking about that I was carefully not drawing, because they ain't there.

What I was going on about is the problem that there's a conflict of
interest between people selling health care insurance and people buying
it, and this conflict of interests may be a side-effect of the market
system itself. (Diabetes was the first example that sprang to mind.
It's not a huge cause of car accidents, either, although it's been
fingered as a contributory factor recently.)

> Healthcare is probably the most heavily controlled industry on the
> planet, and attempting to use it as a demonstration of free-market
> failure seems absurd to say the least

That's not what I'm trying to do. Rather, I'm trying to point out
that free market systems are not very good at globally optimizing
some situations, and if anyone could come up with something better ...

> (particularly when the NHS does it
> so badly, and severely restricts treatment for the elderly folks who
> need it the most).

The NHS _doesn't_ do it badly; it does it very well indeed, given
that it is grossly underfunded and massively oversubscribed. (Compare
the situation with the USA, where per-capital healthcare spending
is 30-50% higher but something like 30% of the population have *no*
healthcare cover at all.) The problem is, life is a 100% fatal
condition, and almost everyone will be willing to spend infinite
resources if they can stave it off for just one more minute; faced
with that kind of demand, what sort of system _can_ allocate
resources fairly?

-- Charlie