Supermarkets provide a
good illustration of why it's not who controls the company that matters it is
the company's effectiveness in the free market that matters most. Supermarkets
like Sainsbury's, Tesco and Morrisons are public limited companies traded on
the stock exchange, whereas with Waitrose the workers have mutual ownership,
and the Co Op is a consumer cooperative consisting of more than 8 million
members having mutual ownership.
What this shows is that it
doesn't much matter who runs
supermarkets, what matters is how
they are run in terms of creating market value. What's creating market value
for shoppers is that all these supermarkets are driven on by competition -
which is why we get multi-buy deals on food, shopper saving incentives, and the
ability to have our groceries delivered to our door if we wish.
The NHS follows a similar
heuristic - as long as it is being run most efficiently, and remains free at
the point of delivery, it doesn't matter whether it is public services running
it or private services. That's because, like supermarkets, market qualities are
about efficiency not ownership. For those who want the NHS to be free from the
more efficient private services due to an almost religious attachment to its
state-ownership, here is a question they need to answer. If they believe
state-ownership is the most efficient way to create value why do they not want
food nationalised too so that supermarkets are under public ownership?
They'll usually argue that
health is different and that you can't subject something as important as health
to the markets. But it shouldn't escape their notice that food is pretty
important too. Without it we'll die. Why is public ownership better in the case
of health but worse in the case of food? No one seems to be able to say, which is
the classic sign of it being merely an emotional bias divorced from evidence
and reason.
The arguments against the
market are too often short-sighted or illogical. The Pope made a similar mistake in a recent
encyclical - arguing that water is such a precious resource that it shouldn't
be privatised. His logic is backwards: resources that are scarce, precious and
valuable need to be guided by market forces of supply and demand, because it
is the free market that most efficiently allocates scarce, precious and
valuable resources, not governments or private interest groups. Around the world you'll
find water shortages are horribly exacerbated by wealthy
interest groups benefiting from water subsidies.
Like water, health is
scarce, precious and valuable. It's scarce because there is huge demand and
limited supply. It's precious because good health is one of the most vital
things about being alive. And it is valuable because our health is what enables
us to work, function and progress in society. Like all things scarce, precious
and valuable, society doesn't need our health services being misallocated or
uncompetitively costed or frivolously managed under the guarantee of taxpayers'
money.
The introduction of more private run services isn't going to impinge on the NHS's free at the point of delivery ethos, so there is no reason to bemoan private health services at all. With an aging population there is ever-increasing pressure on the health service to greatly increase its efficiency and reduce public spending - and that's only going to happen with market forces replacing state involvement.
So please don't panic - market
forces won't affect our ability to have health care readily available, nor will
there be any danger of anyone being turned away due to inability to pay (unlike
the USA
