Health care is about driving science forward, too

Virginia Postrel makes an excellent point in this article in the Atlantic: The US health care system, for all its flaws, drives research forward in a way that no other country can do:

Looking at the crazy-quilt American system, you might imagine that someone somewhere has figured out how to deliver the best possible health care to everyone, at no charge to patients and minimal cost to the insurer or the public treasury. But nobody has. In a public system, trade-offs don’t go away; if anything, they get harder.

The good thing about a decentralized, largely private system like ours is that health care constantly gets weighed against everything else in the economy. No single authority has to decide whether 15 percent or 20 percent or 25 percent is the “right” amount of GDP to spend on health care, just as no single authority has to decide how much to spend on food or clothing or entertainment. Different individuals and organizations can make different trade-offs. Centralized systems, by contrast, have one health budget. This treatment gets funded, and that one doesn’t.

In other words, markets drive innovation – sometimes in directions not deemed to be in the (whole) public’s interest, such as plastic surgery – in a way centralized coordination cannot. It is wasteful, but effective. And somewhere in the world there needs to be some slack for new things to come up, which can then be cost-effectively (or, rather, cost-efficiently) be implemented other places.

Which reminds me of Peter Drucker’s statement: "There is nothing so useless as doing efficiently that which should not be done at all." Not unknown in public health care systems…

(Via John Tierney)