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Originally posted by Mmmm, Burger (C.J.)
The railroads. And even the Erie canal. But what government employee built the interstates? They were built by private contractors with federal money.
And what you're getting at, more generally, is identifying a market failure that gov't action could cure. No one has an incentive to create a comprehensive network of roads, so they didn't. But plenty of private toll roads have been (and continue to be) built, without government intervention. So all you're really saying is that the government did its job in solving a market failure. Not that government does a better job than the market where there is no market failure.
So, in designing health care, you have to identify a market failure that calls for a government-operated solution. The only market failure is not that, but a moral belief that everyone is entitled to "free" healthcare. That's fine, and worth voting on, but it doesn't mean that government needs to be involved in the solution any more than to move money from a rich pocket to apoor one.
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The health care industry is one huge case of market failure. The providers have limited incentive to hold costs down in some areas, because they know the insurers will pay the freight. Consumers are always willing to undergo tests or procedures that are margianl, because their out of pocket costs are essentially fixed. The insurance segment keeps raising rates to pay for increased delivery costs, because major employers and unions will pay the higher premiums in order to attract good labor.
Nobody really has to bear any risk except the consumers who are uninsured or underinsured, and the health care industry dumps most heavily on them becasue they are the only ones without sufficient clout to bargain.
In short, there is not a single patiicipant in the market for health care who actually deals at arm's length in a risk-reward setting.
