Re: Gov't loves Gov't

Mark Grant (
Thu, 22 Jan 1998 11:53:38 +0000

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

Which ones? You said that untreated diabetes caused lots of road
accidents, which should be impossible if the NHS was doing a good
job of treating them. You also said that there was no health
insurance market in the UK because of the NHS.

>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.

Yes, but there's always a conflict of interest between people who
want more money than they have, and people who don't want to pay.
I don't see how this can ever be avoided.

>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 ...

But we don't have anything like a free market in healthcare, so
you can't claim that healthcare problems are free market failures.
For all I know, if diabetics couldn't get cheap health insurance
in a free market they would have got together and paid researchers
to find a cure. That won't happen in a controlled market.

>The NHS _doesn't_ do it badly; it does it very well indeed, given
>that it is grossly underfunded and massively oversubscribed.

According to what I've heard/read/seen on TV from NHS doctors
the NHS denies many treatments for those over seventy (sixty?),
puts others on waiting lists which can last for years, and routinely
lets people die to save money. Is this good healthcare?

>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.)

Do you really think that healthcare in the US is a free market? It's
less government controlled than the UK, but that's 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;

Yep, which is one major reason why healthcare costs in America are
so much larger; when an NHS doctor would be allowing a patient to
die, US doctors will continue expensive treatment.

> faced
>with that kind of demand, what sort of system _can_ allocate
>resources fairly?

A free market?