I’ve known that George Bernard Shaw had a thing or two to say about conflicts of interest in the medical profession, about how doctors have a direct pecuniary interest in providing you with services (for which they charge a fee) rather than in keeping you well (in which case they don’t).
GBS was an early pundit on the problem that now goes by the name of asymmetric information. Nevertheless I hadn’t been prepared for such a blast from his first para.
It is not the fault of our doctors that the medical service of the
community, as at present provided for, is a murderous absurdity.
That any sane nation, having observed that you could provide for
the supply of bread by giving bakers a pecuniary interest in
baking for you, should go on to give a surgeon a pecuniary
interest in cutting off your leg, is enough to make one despair of
political humanity. But that is precisely what we have done. And
the more appalling the mutilation, the more the mutilator is paid.
He who corrects the ingrowing toe-nail receives a few shillings:
he who cuts your inside out receives hundreds of guineas, except
when he does it to a poor person for practice.
Read a whole lot more if you want here.
Nicholas, there’s an interesting proposal that Grassley & Baucus have put up in the US. I don’t think it goes as far as you’d like, but I’d be curious on your views about it nonetheless.
http://www.nytimes.com/2006/12/12/washington/12health.html
Shaw had a horrendous and long drawn out experience with a diseased foot which began from lacing up one of his shoes too tightly & ended with surgery for necrosis of the bone and marriage to the lady who nursed him – I’ve often wondered if Stephen King got the idea fro the plot of Misery from this episode.
There are probably more effective ways for the US government to spend the money:
Drug companies’ objective is to maximise their sales. The health system’s objective should be to treat according to best evidence. These are not at all the same thing.
The full transcript for this Health Report program (12 June 2006) is at http://www.abc.net.au/rn/healthreport/stories/2006/1657545.htm
Eric Rasmusen discusses another quote from George Bernard Shaw to do with Economics in the introduction of the following book:
Rasmusen, E (2005(?)), Games and information: An introduction to game theory (fourth edition), Basil Blackwell, Great Britain(?).
This book is available online at the following website:
http://www.rasmusen.org/GI/download.htm .
The following quote comes from page 4 of the above book:
That is unbelievable. An economist wrote that in 1885! I was just arguing with an economist friend recently about that very question. My issue (coming from a political background) is that symbolic logic, while helpful in many circumstances, tends to obscure questions of quality and interrelation. There are people in the World Bank, for example, who obsess over ‘social capital’, trying to show that an x increase in social participation will result in y effect for society. To simplify such a complex situation is insanity. Every time the term social capital is mentioned you can faintly hear a sociologist’s teeth grinding somewhere in the distance !