Comments on: Beating the endowment effect: denationalising healthcare, step by step http://blog.iea.org.uk/?p=585 institute of economic affairs Tue, 07 Sep 2010 12:51:39 +0100 http://wordpress.org/?v=2.8.5 hourly 1 By: Kris http://blog.iea.org.uk/?p=585&cpage=1#comment-28863 Kris Fri, 23 Oct 2009 09:20:46 +0000 http://blog.iea.org.uk/?p=585#comment-28863 Peter, here we're back to the question who ultimately drives changes, politicians or intellectuals (in the Hayekian sense). I don't think politicians have any incentives to implement changes in the outlined direction, unless pressurised into doing so by public opinion. And the public mood, I guess, won't change until at least a large minority among opinion-makers start blaming the NHS's failures on the NHS. Not on a particular directive, PCT managers, or poorly defined targets. Mark, I see why it could make sense for some healthcare providers to rent, not own, facilities. But why should they be owned by the government? Why shouldn't private developers buy, equip and rent them out? Peter, here we’re back to the question who ultimately drives changes, politicians or intellectuals (in the Hayekian sense). I don’t think politicians have any incentives to implement changes in the outlined direction, unless pressurised into doing so by public opinion. And the public mood, I guess, won’t change until at least a large minority among opinion-makers start blaming the NHS’s failures on the NHS. Not on a particular directive, PCT managers, or poorly defined targets.

Mark, I see why it could make sense for some healthcare providers to rent, not own, facilities. But why should they be owned by the government? Why shouldn’t private developers buy, equip and rent them out?

]]> By: Mark Wadsworth http://blog.iea.org.uk/?p=585&cpage=1#comment-28348 Mark Wadsworth Tue, 20 Oct 2009 13:34:05 +0000 http://blog.iea.org.uk/?p=585#comment-28348 That seems like a very good plan, except: 1. The NHS should rent out its existing land and buildings rather than sell them for a one-off lump sum, otherwise it'll end up selling the stuff for less than market value (and it will have a nice source of future income that claws back some of the excess payments that they make to providers). And if the new organisations can rent rather than buy that reduces their commercial/interest rate risk. 2. I don't agree with 'opting out'. That makes the tax system more regressive. Far better for the NHS as funding body to have a defined list of 'essential' treatments and the amount it is prepared to pay towards the cost of each. That seems like a very good plan, except:

1. The NHS should rent out its existing land and buildings rather than sell them for a one-off lump sum, otherwise it’ll end up selling the stuff for less than market value (and it will have a nice source of future income that claws back some of the excess payments that they make to providers). And if the new organisations can rent rather than buy that reduces their commercial/interest rate risk.

2. I don’t agree with ‘opting out’. That makes the tax system more regressive. Far better for the NHS as funding body to have a defined list of ‘essential’ treatments and the amount it is prepared to pay towards the cost of each.

]]> By: Peter King http://blog.iea.org.uk/?p=585&cpage=1#comment-28307 Peter King Tue, 20 Oct 2009 10:28:56 +0000 http://blog.iea.org.uk/?p=585#comment-28307 Kris, This is really interesting and well thought out, but what concerns me is how we might persuade politicians even to start on the process: just what incentives are there for politicians to seek such a radical transformation? Kris, This is really interesting and well thought out, but what concerns me is how we might persuade politicians even to start on the process: just what incentives are there for politicians to seek such a radical transformation?

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