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US: Health care

Cameron Sawyer, an American businessman located in Moscow, disagrees with Eric Weiss, MD: "I don t often disagree violently with WAISers, but here I beg to. Health care is a service, which requires capital and labor combined in some way to result in production. How do you propose to avoid strict business rules ? Magic? The choice for the production part of the equation is to either allow market forces to work that is, don t restrict doctors, hospitals, pharmaceutical companies from investing capital and labor into producing services they can sell at prices freely determined by the market, allowing competition to control prices. Or organize production according to command (i.e., Soviet) principles provide the services directly by the state, finance the provision of services according to prices fixed by the state, or simply fix prices by decree. It is well proven after the tragic experiments of the last century that the former system results in efficient production, which means more and better services are provided for less input. The latter system results in disastrous inefficiency, underproduction, misproduction, poor quality, and poverty. Every time.

As a civilized society we are unwilling to tolerate poor people being denied access to health care because they can t afford it. So we must temper the rigors of the market with some kind of safety net. But if we want good health care, and want to avoid impoverishing ourselves as a nation, then we must find a way to provide the safety net which is a moral imperative with the least interference with the efficient working of the market, which is the only mechanism of efficient production known to mankind, despite thousands of years of experimentation. Market forces are NOT the principle driving force behind health care services in the U.S., where the supply of doctors is artificially restricted, where insurance companies dictate bizarre practices, where a huge part of the health care sector is dominated by Medicaid and Medicare, and where our absurd tort system hangs like a cloud over the whole system. We are very far indeed from a shining example.

RH: Cameron asked me if it is WAIS to disagree violently. Since Moscow and Stanford are some 6,000 miles apart as the crow flies, and neither nor Cameron nor Eric fly like crows (at least, I have not seen them do so), I see no problem. Moreover, Eric is in charge of the emergency ward at Stanford Hospital, he must know how to deal with the results of violence. I would say, however, that in general, WAISers should disagree vigorously, not violently.

Ronald Hilton - 3/19/03