Yes Diane

And more fundamentally, because of these changes, the NHS will morph from a directly managed system of healthcare into a regulated industry of competing providers. It is the difference between an army run from the centre and the government giving over the defence of the realm to a bunch of competing mercenaries. (Obviously they would need a regulator. Ofsick, perhaps?) The Tories would not dream of organising defence in this way. Why are they introducing this system for healthcare?

Err, because defence is different from health care in a fundamental manner perhaps?

Because health care is more like food, education, housing, than it is like defence or the criminal law, where we desire and need a State monopoly?

9 thoughts on “Yes Diane”

  1. The last time that national defence was entrusted entirely to foreign mercenaries the standard of living didn’t recover for more than a thousand years. At least if you measure it by the chances of getting a hot bath.

  2. As a card-carrying bleeding-heart liberal,I’ve never seen the problem with mercenary armies.In fact the army and the supply of alcohol are two areas where unconstrained market forces might do a lot of good. Robert Clive won the Battle of Plassey by bribing one lot not to fight: cuts down on the bloodshed.From a Libertarian point of view , I can( just about) imagine that the Citizen Army of conscripts and volunteers is the beginning of the Modern State with its education system ,health service etc all there to avoid the disaster of the Boer War recruiting campaign when the feeble products of the factory system were too unfit to be enrolled and shot at by a lot of farmers.”Statism” stems from the need for cheap cannon fodder not socialism or fascism which came along later.Statism=Militarism.

  3. Thinking of defence in that way. Maybe there would be some merit in issuing Letters of Marque to people interested in sorting out the pirate problem around the Horn of Africa.

    I am sure that the shipping giant’s would like to see an end to the problem, and would be minded to pay for a solution, rather than the huge insurance that they are currently having to deal with, thus we could see a privateeer approach.

  4. Britain is a very high cost country. According to this – – chart 3 says that the UK outspends China at market exchange rates. Wouldn’t it therefore make sense to outsource defence to China (as we already have our manufacturing) and get armed forces in the millions rather than agonising about recruiting in the thousands? Any unreliability issues could be addressed by incorporating suitable terms in the service level agreement.

  5. The royal navy did very well when the prospects of prize money added a Free Market edge to them, not that that is really the point. In order to allow people to live their lives without constant danger society evolved so that the state has a monopoly on violence (though the left would love to break that particular state monopoly), mean defence, courts, and later police. Everything else is secondary and might be usefully funded through taxation, or not.

    One thing that is strange is how reactionary so called progressives are. It does not matter whether the change leads to better outcomes, as moving closer to the best system in the world surely will. To them any and all change must be stopped simply because it is change.

  6. “how reactionary so called progressives are”: it applies in the arts too – there’s nothing so conservative as the avant garde.

  7. I don’t get your point. National defence and health care are both non-excludable. And the first you need defence from invading armies, the second you need defence from invading germs.

    Plus, your response suffers from the following retort: Yes we need a State monopoly. But which State? Why the United Kingdom of Great Britain and Northern Ireland? Why not Europe or Earth or England or Your Region or Your County or Your City/Town/Village or Your House or just plain old You? Why are you submitting to coercion by not just accepting this State’s monopoly on violence, but by justifying it also?

    Tim adds: Parts of health care are indeed non excludable (and also non rivalrous) and are thus public goods. I myself often use the example of vaccinations as such (herd immunity and all that). But that something is a public good simply means that it’s a good idea to subsidise production of it through the tax and spend system: nothing in the definition of a public good leads to the conclusion that the State should be the monopoly supplier.

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