Wednesday, February 1, 2023

Speaking of oracles

This is Joseph

Marginal Revolution pointed me to this quote by Peter Thiel:
[Thiel] has described British people’s affection for the state-backed health service as “Stockholm syndrome.”

The venture capitalist’s comments came during a Q&A session after a speech at the Oxford Union, a 200-year-old debating society, on Monday. He also said that the crisis-stricken health service, currently grappling with strikes and long wait times for emergency care, was making people sick and needs “market mechanisms” to fix it. Such mechanisms include privatizing parts of it, avoiding rationing and loosening regulations…

“In theory, you just rip the whole thing from the ground and start over,” Thiel said after an address in which he argued that a perceived fear of disruption was holding back technological and scientific developments. “In practice, you have to somehow make it all backwards-compatible in all these ridiculous British ways.” 

Let me be blunt. I can improve any pension plan by starting over and no longer needing to pay out previous obligations. It's trivial.

The political challenge is that older adults have paid into the NHS their entire working life. The National Health Service (NHS) started in 1948, only a few people over 90 will have worked at any point in their career without contributing to the national health care plan. Tear it down might be ok, if and only if the new package of services are equivalent. Privatizing and avoiding rationing, together, make it hard to see how services can be maintained. Further, if a major infrastructure projects go way overtime or fail then that is one thing -- but if it is an entire healthcare system is being rebuilt there is a lot of risk inherent in loss of services or poor performance. 

How can you impose a market mechanism without these risks? Now maybe radical change is a good decision in the face of an unsustainable problem. But let us not fool ourselves that it will be  cheaper, just as comprehensive and have equal or better outcomes. 

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