Kaleidic Society

Healthcare and Rationing

Currently, many experts are denying the claim that a government run healthcare service would need to ration out care to patients. However, this impossible. Just like the free-market, which "rations" according to ability and willingness to pay, a government healthcare service does not have unlimited resources (although it may be well-funded), so it must also ration care to its clients. Therefore, the question is not whether there will be rationing, but how it will occur and who will guide it. In itself, this doesn't show that free-market healthcare or government healthcare will be inherently better. But we can use the insights of public choice and standard theory to show that, at the least, we shouldn't expect the government to outperform the market without extremely extenuating circumstances.

In particular, without real market entrepreneurs guiding the healthcare process, it seems unlikely that a dynamic system with ever-changing and improving medical technology would result. As Lachmann constantly emphasizes, the marketplace is a zone of incredibly dynamic and often unpredictable progress, guided by entrepreneurs who must interpret data and form expectations in accordance with their accumulated knowledge. Government, on the other hand, often seems to be in a sort of stasis, only changing at regular intervals and unbothered by the threat of competition.

 

Comments

DD5 said:

"But we can use the insights of public choice and standard theory to show that, at the least, we shouldn't expect the government to outperform the market without extremely extenuating circumstances."

Why be so charitable?

In the absent of free market prices, there is no rational way to allocate any resources.

You seem to be fixed too much on the incentive problem, but what about the information problem?

The government of course, will ration, and will ultimately decide what to produce, how much, and where it goes.  So you don't need a formal death panel to decide if grandma lives or dies.

# August 24, 2009 4:27 PM

ziragt said:

You're right about the informational problem and this relates to the entrepreneurial function. Entrepreneurs need both competition and prices to act as constraints and, in Mises' words, "aids to the mind," respectively. They use the information given by the price system to rationally allocate resources. Without this, a government system will find it almost impossible to allocate services to those who most need them.

# August 24, 2009 10:08 PM