[Marxism] Healthcare Follies
acpollack2 at gmail.com
Sun Jul 6 08:03:38 MDT 2008
Michael, you make a lot of great points.
One note on Coase: I would argue that the VA system -- and other integrated
systems, including Kaiser at its best here, and socialized medicine systems
from Cuba to the UK -- show that transaction costs can also be minimized by
expanding the boundaries of the firm, and thus limiting needless
transactions between different components of them that are necessary when
they are freestanding economic actors, whether patients, clinicians or
Which brings us back to the question of socialized medicine that you said at
the start of your speech you wouldn't deal with.
By the way, the latest scheme to bring market mechanisms to healthcare --
"Pay For Performance" -- is an unwieldy, Rube Goldberg-like contraption that
grafts on incentives to a select group of hospital and physician processes
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