Paul Birch

The worst effects of welfare socialism take time to develop; there's a ratchet of ever-increasing inefficiency. The longer you deprive an industry of the discipline of the market, the less efficient it becomes; after a while no one can remember what efficient organisation looked like, or has any real idea of what they are doing badly or how to improve. You can set targets, but without a market price there is no objective method of weighing their respective values. How many fillings equals one crown? Are more extractions good, a measure of productivity, or are they a sign of failure, a lack of effective preventative treatment? This is known as "the calculation problem" and bedevils every form of socialism or dirigism.

It is true that a number of dentists have in recent years loudly proclaimed their intention of going private - but that's mainly a bargaining chip to get more money from the state. Overall, there was probably more private dentistry in the 70's than now. However, even so-called private dentists don't operate on an open market; they have what amounts to a trade union or medieval guild that prohibits free entry INTO phpbb_the profession, and has bribed, blackmailed, bullied or deceived successive governments INTO phpbb_enforcing this professional monopoly. This artifically reduces the supply of dental services and radically inflates the prices they can charge. They pretend it's all to keep up standards, but in reality it is indeed based on greed.

Bryan Parry

>>>>>>
The longer you deprive an industry of the discipline of the market, the less efficient it becomes; after a while no one can remember what efficient organisation looked like, or has any real idea of what they are doing badly or how to improve.
<<<<<<


No offence Paul, but that doesn't sound like a particularly coherent argument (i.e. it sounds more like an assertion of your views and not an argument). Certainly I agree with the basic point, but I don't see how it is appropriate to have some things not run by the state*, or at least having some state participation (tooth care, in this conversation). Folks like me can't afford damned private dentists anyway- the only way I am going to the dentists is if it is free, or costs nothing. What do you say to that?


*note: most things should not have the state invloved, though, in my view

Paul Birch

If you read the whole of the paragraph, not merely the first bit, you'll see that it does indeed outline an argument. There are whole books (such as von Mises "Socialism") devoted to fleshing it out.

When one starts something like the NHS, its personnel, previously in the private sector, know how an efficient hospital is run; initially it will be run well by dedicated people; but memory fades and times change. There is no longer any objective way of measuring customer satisfaction (in a free market operation this is measured simply by how much individuals are willing to pay), but this information is absolutely vital for rational economic planning; we cannot know what services to provide, or what level or quality of the various services, if we do not know what those services are actually worth to the customers - in hard cash. Is a marginal reduction in waiting time worth more or less than a marginal reduction in beds per wards? In the absence of a market, no one knows. Even the customer doesn't really know the value of those services to him until he actually buys them. That is the essential information the market generates, and the longer you try to get by without market prices the more out-of-date your data becomes. Political lobbying is no substitute, because it glosses over the crucial fact that everything in economics is a trade-off; more of one thing means less of another.

Who happens to run or own a service is secondary; what matters is the free market. If a state runs a service competitively, without using its police powers to ban, license, regulate or otherwise penalise the competition, or using enforced exactions (taxes) to subsidise its own operations, then there's no problem; the state service will have to be efficient or go out of business, like any other firm. Sometimes, as with roads (but almost certainly not with dentistry) the market solution is likely to be a near monopoly (but not a regulatory monopoly), which may well be publicly owned.

The free market price of dental care would be far below the prices we currently pay, even on the NHS, never mind the price we currently pay in high taxes.

B.A.Ware

Paul If I am reading your postings right what you are saying Is everything should have a free market price this intern will drive the market and be a measure of customer satisfaction and a drive for efficiency.
So if we apply this theory to the NHS. All NHS hospitals will be free to charge patients x for x treatment. Therefore it would follow that hospitals would be price driven, hospitals would set in place efficiency programmes and the treatments they supply would become commodities. The efficiency drive would have to reduce the price of the commodities to satisfy the customer.
So the cost becomes more important than the patient because the focus would be on the price of treatment. Would hospitals then concentrate on high margin treatments to increase profit margins e.g. 10 hip operations per day = more profit than one heart bypass.
if money becomes the driver care goes out of the window Look at factory farming, people are driven by profits and have minimal concern over the animals welfare, I know people still buy the food produced there, most people prefer to be ignorant of the conditions the meat was produced. The point is factory farms were set up to maximise profit and for no other reason.

Bryan Parry

Yes, there is a very fine line. When trodden over, we enter "AARGH FREE TRADE IS EVIL!!!!11" socialist territory. But I do think Paul's faith in the free market is ever-so-slightly beyond what it should be... but I know how well Paul can argue, and thus I can't even be bothered to counter-argue (especially given we are reasonably close together on a bunch of issues, anyway). Yes, that is laziness for you, but I am a student, so there :P

B.A.Ware

Yes Paul is very good at putting his point across and some of his arguments sway me but I do not think he takes other peoples ideas on board. He will listen to them knowing full well what ever the point is he will not move from his position its a free market or nothing.

Where I believe something’s are just not able to function fairly on a free market. What’s fair and profits do not go hand in hand. Look at Shell and BP the market does not set the price of oil they do. If there’s oil in a village in Africa, stuff the villagers we will buy the government and kick them out.

As for Paul’s arguments break them down and address each one separately. i.e.

“It is true that a number of dentists have in recent years loudly proclaimed their intention of going private - but that's mainly a bargaining chip to get more money from the state”.

This not fact its opinion, my opinion is they went private for the money (why bargain with the state for more money when you can go private and get even more)

“Overall, there was probably more private dentistry in the 70's than now”

Again opinion or why use word probably, my opinion, in the 70s people had a lot less disposable income and could not afford to pay for dentists. People have a lot more disposable income now so dentists can charge more so they set up private practises. I could go on but I wont. Anyway aren’t you meant to be in a students bar studying, why do you think I pay my taxes for.

Bryan Parry

GET A GRIP MAN!! Bar, sure, but studying...

B.A.Ware

Perhaps you should be studying for the Bar exam, I can recommend it I’ve passed it loads of times. 8)

Sarumano

If we put a) Sister/Charge nurse in charge of a ward and let them have autonomy and responsibility... b)"Matron" in charge of a hospital area, ditto, you'd lose swathes of penpushers, especially if you tell a) and b) above that filling in forms is not a priority, running a ward smoothly IS. The only paperwork that matters is the patient record and the accounts.

Ditto teachers, police, headmasters, stationmasters...

We will need inspectors (single) whose job it is to blow whistles and thump heads if a job is NOT being done, but basically you trust the guy you gave the job to.

Oh, and turn personnel departments around to support the personnel, not the department head.

mkpdavies

Spot on!

Most people get on with the job they are given, especially people who become teachers, doctors police etc. If you trust people from the ground up, the difference would be massive.

People will take pride in their work again, instead of feeling that they are banging their heads against a brick wall. Morale of staff is everything when it comes to customer service.

The argument I can't stand, but I hear all the time, is we have to have measurements. Of course there are certain things you can measure easily, such as number of people in prision, number of people coming out of hospital alive. The rest of it, including staff recording their hours worked and what they were doing in those hours are a waste of time. The figures are massaged up to and including the government level, so you have rubbish in and rubbish out. What use is that to anyone?

Trust the staff from the bottom to the top and you will see massive benefits all round. If there are rogues, the pride of people working with them, along with the people in charge them will take care of it. I look at first level managers now and all I see is messengers. They have not power to do anyything, thus they don't care. They just feed the beans that those above them want to hear, who then massage and do the same upwards. It is a farce.

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