National Health Service

The government is again talking about fixing our health system. I am glad. I hope they really fix it this time. In the meantime, I thought I would share my thoughts on the subject.

I am a capitalist. I believe in the free market, and using market incentives to optimize social systems. But with healthcare, I don’t believe that this works. People do not shop around for price when they are sick. When in the hospital, you take the pill they hand you; you don’t ask how much it costs. Even when people do shop around, they almost always look for the best doctor, not the best cost. So providers have the incentive to be the best, regardless of the cost.

Right now the only companies really making a lot of money at healthcare are the drug companies. They are making some pretty extraordinary drugs, and while the patents hold out, they make good money at it. But there is no incentive to cure disease, only treat it. What are the big new drugs? Drugs for Aids, mental health, allergies, and ED are the big drugs. They all treat disease. The best thing a drug company can do to maximize its profits is to develop a pill that will treat a common disease with one pill a day for life. If you cure your customer, they don’t need you any more.

So what is the solution? Public health care, socialized medicine, call it what you like. Everybody needs healthcare. Not just those who work. Not just those who work for large generous companies. People often need healthcare more when they are not working than when they are.

Are there downsides? You bet! Public healthcare is just like any other public service run by the government. There are politics and inefficiency and bureaucracy. Think IRS, DMV, or the department of public works. But the school system, the military, and first responders (fire, police, etc.) are public too. Still, in spite of likely lines, and long waits, and mixed quality, I believe it is far better to provide adequate medical care to everyone than good care to just a few. And I believe government doctors are better deciders of who should get care than insurance companies, lawyers, and luck.