Private means and Public Ends
When I need health care, I wish I could go to a facility whose purpose is to provide health care. And that those in charge of paying for my health care were motivated by concern for my wellbeing. There are no such institutions available to me. All the clinics and hospitals around me exist to make a profit, not to provide health care. In fact the provision of health care is something of a nuisance to them, a nasty little obligation that stands between them and my money. My insurance company is basically in the business of limiting the care provided to me in order to maximize their profits. Their de facto motto is “A treatment denied is a profit made.”
I don’t mean to suggest that the individuals who provide treatment—physicians, nurses, technicians, etc.—lack concern for the people whom they treat, but they are embedded in a system that often prevents them from taking the actions that they believe would be best for their patients.
Why is it that those nations with publicly funded health care are able to provide state-of-the-art healing services for all their residents at half the per-capita cost of America’s shoddy system, which fails even to cover a large portion of the population?
Likewise, when I search for, say, an internet provider, I would like to find one whose purpose is to provide me with the best possible service. I do not have that option. All I have is a choice among profit-motivated providers whose interests are best served by charging as much as they can get away with in exchange for the cheapest possible infrastructure and service. Does competition really exist in this arena? Would I be better off with a government-run system that was dedicated to providing service rather than rendering a profit to its owners?
And education—would we be better served by an institution whose purpose is to educate, or one whose purpose is to return a profit? Why should we expect that a system in which policy decisions are made on the basis of financial analysis (and often short-sighted analysis at that) would out-perform one whose decisions are made on the basis of what will be best for the students?
One could go on, sector by sector, in each case concluding that institutions whose goal is to make a profit may not be the best choice for delivering vital public services.
To quote John Maynard Keynes, “Capitalism is the astounding belief that the most wickedest of men will do the most wickedest of things for the greatest good of everyone.”
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