A conservative (free markets and such) friend and I were having a private conversation about healthcare when he asked why there was so much waste in our healthcare system, i.e. why was the cost of actual care so low compared to how much we spend.
Here’s my answer, edited for clarity:
The waste you’re alluding to is caused by the injection of greed and profit into the system. There are thousands of “medical” companies that do nothing but figure out how to charge the absolute most for their products or services. What else would a business do?
Essentially, the goal of high quality healthcare at a low cost is not in harmony with a free market approach for the simple reason that the incentives are not aligned. Businesses are there to make money, and if they make MORE money by charging way too much for services, then that’s exactly what will happen.
Case in point: we pay far more for healthcare in this country and have worse outcomes. The problem with healthcare in the US is simply that it’s being destroyed by parasitic profit seekers. Doctors. Hospitals. Companies. They see medicine as a way to make money, and they act accordingly.
Profit and core services should be mixed extremely carefully, and in very small amounts.
He then goes on to say that he doesn’t agree with people being told what to do, in virtually any form. My response to that was:
Here’s a remarkable secret: people don’t magically become educated and wise when they turn 18.
If kids want to play in the street at age 17, and adults are allowed to tell them not to, then what REALLY changed when they turn 18 and want to spend all their money on lottery tickets instead of education for their children?
Your position of assuming that all adults are equally capable of making good decisions, and therefore need no guidance, is simply and fundamentally flawed. It is a fiction.
Once one realizes this it becomes abundantly clear that helping others through policy is not just acceptable, but a morally self-imposed requirement.
One should not sit back and watch the ignorant flounder in their own misery. We should try to help them.