I have been reading an article online regarding the role the government should play in public healthcare, mostly in the American context. Now, I know little about economics, however, I believe that we do not need to know much about economical theories to figure out some very simple, basic principles for ourselves.
I want to point out that healthcare, falls under the class of things called public goods. Public goods are things like, national defense, education, and of course, public healthcare. Note that this class of things is very different from things that fall under the class of businesses, such as those that we would typically find in a market. I will give an example of the latter: A burger joint, or a coffee chain, or a bookstore, or a car mechanic, that sort of things. Basically, they produce something, then sell it to make money, and in the process making a profit. Now, this distinction is important, because we need to realize that the pursuit of profit only sometimes converges with the increasing of human happiness (or the reduction of human suffering, which is pretty much the same thing). And in the case of healthcare, the pursuit of profit often directly runs counter to the reduction of human suffering. I will give an example of how the pursuit of profit sometimes converges with the increasing of happiness: Imagine that there is a burger joint. They make delicious burgers. You go to their restaurant, buy a burger, which gives them a profit. You eat the delicious burger, and your happiness goes up. This is when the owner of the burger joint will say that his business serves a legitimate function, because even though his ultimate aim is to make a profit, he does also provide some kind of benefit, and he does, because his burger gave you an increase in happiness. Now, I will give an example of how the pursuit of profit will actively run against the increase of happiness/the reduction of suffering. Imagine that there is a hospital. There is a cancer patient, who is crying out in pain. Now, the staff at the hospital has two choices: Give him a painkiller to relieve his pain, which would result in the reduction of his suffering, however, it will give them a reduction in profit, as painkillers cost money. Or, they could choose to just let him cry, and not give him any painkillers, which would increase their profit, as they would be saving money by not giving out their painkillers. If you are a believer in that healthcare should be run like a business, as in, you should healthcare would be more "efficient" in a free market-style environment, free of government intervention, then the necessary conclusion is that the hospital should act in pure, rational self-interest, which means they should withhold the painkillers from the cancer patient, so as to save money. Which of course, would result in suffering going up. And it's not simply a matter of us saying that the staff should give the painkillers to the patient. Of course we can tell them to do that, this is easy enough to do, however, another hospital that is willing to withhold the painkillers will always have an edge over the one that is not willing to just let the patient suffer. This is an inherent part of being a profit-seeking business. This imaginary example is simplistic, but nevertheless I believe it captures my point very well, and that is, when it comes to public goods like healthcare, it is a very bad idea to run it like a profit-seeking business. The reason that such a debate even exists is because Americans have an innate dislike of government intervention in spheres of the public life; they see this as communism or socialism. I just want to tell them that the issue really goes beyond left wing-right wing, capitalism versus socialism. It comes down to something that's actually not that political anymore and is in fact something more philosophical, namely that the pursuit of profit is fundamentally incompatible with the having and delivering of public goods. We see a similar theme with national defense, too. Nobody in their right mind would suggest we run the armed forces like a business, and that is because not only is there pretty much no opportunity to make a profit, one would actually have to sink money in, to generate some kind of result. And this result, though it's something that is very good, namely the ability to defend our country from foreign threats, is nevertheless not a profit. Hence, national defense should not be run as a business. There simply is no profit in it. If a business actually tries to run it with the aim of obtaining a profit, it will not only fail, but it will also imperil our country. So, I hope this again reinforces my idea that things that are of the public goods nature, should not be run like a business. We should leave it to the government, not because the government will run it well, but because if we leave it to the "market", it will be even worse.
A related topic: Some people are talking about the role government should play in the training of medical doctors. For example, they talk about whether the government should subsidize medical training and things like that. I just want to say how I feel: In my country, which is Canada, there is a phenomenon called brain drain. Basically, it is a situation where Canadian-trained doctors, upon receiving their license, move to the US in search of higher pay. I remember eyeing these medical students with resentment. I remember thinking to myself, "You take up spaces in our medical school programs, spaces that could have gone to people who actually cared about serving Canadians and caring for their health. When you are all trained up, you go somewhere else, only to make more money for yourself. Do you care about anything else? Do you care about the fact that there are a huge number of Canadians who cannot find a family doctor?". I didn't understand why we allowed such a thing to happen. Why should we waste our educational resources on people who only care about making money? I believe that the ultimate goal of our schools is to train people so that they can help and serve the population that they are a part of. These people should have a stake in our country, whose well-being and prosperity they should care about. And if in serving Canadians like that, they also make a nice income, that's pretty nice and I see nothing wrong with it. But if we just train people in the hopes that they might deign to stay around and serve our populace like they are doing us a favor and that we should be so grateful for these intellectually elite professionals to want to serve us, then we are totally going about it wrong. My solution? Make it so that it's like a contract. Any student who is accepted into a medical school should sign a contract with the government promising that they will serve Canada for a certain amount of time. After this period is up, then they are free to go elsewhere. We already have something similar to this in the private sector. I believe that some companies send their employees to training and make them sign a contract promising that they will stay with the company for a certain amount of time before they can go for other opportunities. It sounds very reasonable to me.
The two issues I mentioned really don't have too much to do with healthcare. They have more to do with how we should organize our societies. Also, for my second point, what role that certain actors of our societies should play. We should recognize that everybody that exists in a society does not just have entitlements to resources, they also have obligations, some sort of responsibilities, towards the society that has provided for them in many ways and is in fact a very big reason that they are able to be the successful individuals that they are today.
Another thing: I have noticed that people tend to talk about things in a way that is very difficult to understand. I am someone who has some college education under her belt, so I think I am pretty representative of the level of the understanding of the public when it comes to matters like this. And I find it difficult to follow the discussion ( You can see what people talk about in this link:
https://www.econlib.org/health-care-markets-fail-so-government-must-intervene-kenneth-arrow-said-no-such-thing/). I don't know why people talk that way, do they see no need to dumb it down because they feel that they are talking to their intellectual peers, whom they feel should know about this stuff? Or are they trying to show off how learned they are? If it's the former, I apologize. If the latter, then I really want to let people, and not just the ones in the link I provided, but everybody in general, know that our role as the intelligentsia is not to sound smart and feel superior to the masses. Our proper goal should be to act like the guiding star, and show people the way out of the messes we find ourselves in. And the way to achieve that, is by talking in a way that people can actually understand. In other words, we should strive to talk like the way I do, right here in this post and the one that precedes it. We want people to understand us, we don't want people to admire us.