[ExI] Why Cities Keep Growing, Corporations and People Always Die, and Life Gets Faster

[Rafal Smigrodzki]

2011/6/7 Stefano Vaj <stefano.vaj at gmail.com>:
> On 6 June 2011 16:27, Reason <reason at fightaging.org> wrote:
>>
>> > where medical services are still offered by private entities for a
>> > profit, and the government does not do anything else than footing the
>> > bill...
>>
>> > BTW, it is not clear to me why Americans call "socialised" a system
>> Some fairly clear reference material for that viewpoint:
>>
>>
>> http://www.fightaging.org/archives/2009/10/the-doom-that-fell-upon-medical-p
>> rogress-in-the-us.php
>
> Mmhhh. In URSS they decided to save on glasses and they experimented with
> cheratotomy. Why shouldn't that qualify as "innovation"? Socialised medicine
> has the same interest in being efficient as socialised manufacturing of
> weapons. Because otherwise its managers are shoot or replaced, for instance.

### You are correct. Russians were actually quite good at making
weapons, in part because they used some market-like management methods
in their military industrial complex. There were always multiple
competing design teams for any major weapon system (think Yakovlew vs.
Suchoi vs. Tupolev), the winners got dachas and permits to live in
Moscow, the losers were sent to Yakutsk.

-----------------
>
> OTOH, probably a private hospital whose invoices are paid by the government
> no-matter-what has no real interest in being efficient. If anything, the
> more it spends, the more it can claim it "has" to ask for...

### Again, correct. A single-payer system removes the primary feedback
loop that normally optimizes interactions in the market, the loop
between user of services (in this case the patient) and the provider
(the physician), and replaces it by a loop involving patient=taxpayer
> politician > appointed bureaucrat > lifetime bureaucrat (i.e. direct
Medicare supervisor) > lifetime bureaucrat (hospital administrator) >
physician > patient=taxpayer.

Rafal