Zoe Williams on health care monopolies

Often the private company is only cheaper until it\’s the only provider – then it is suddenly radically more expensive, but there\’s nothing you can do about it.

You\’re quite right of course Zoe. Monopoly suppliers do tend to exploit their monopolies.

This is of course the reason to bring competition into the NHS. To stop the NHS exploiting its monopoly.

That is, your point is an argument in favour of competition, not one against it.

12 thoughts on “Zoe Williams on health care monopolies”

  1. “Often it fails to build up and reward pro-social behaviour (a psych word for “kindness”) in its staff, because paying them so little exhibits so little kindness towards them.”

    Those NHS nurses who have been leaving patients to die in their own shit, or letting them die of thirst (don’t worry, it’s not a problem, PaulB says it’s all written down somewhere) – they’re exhibiting lots of kindness.

  2. Isn’t the NHS as much a monopsonist as a monopoly? Which might be bad for medical suppliers/employees, but not too bad for the rest of us?

  3. Surreptitious Evil

    Isn-t the NHS as much a monopsonist as a monopoly?


    Which might be bad for medical suppliers/employees

    There are unjustified presumptions of competence in NHS purchasing and NHS freedom (from political interference) in the setting of pay scales. Both, in fact, are fully “producer captured” in a way that more than negates any monopsony effect.

    And, of course, NICE doesn’t help either …

  4. So she fails on:
    1. Not realising NHS is a monopoly.
    2. Not realising that a single private company can’t replace the NHS monopoly because they can always be undercut or out-competed.

    Outstanding levels of stupidity. Should be bottled.

  5. Oh I can’t be arsed to recreate in full. But stuck record you seem to be saying that a monopoly cannot occur as it will be undercut or out competed. Surely no one believes that?

  6. Both she, and all of you, fail on not knowing that PbR, introduced in 2004, fixes prices for given treatments (competition is on quality). So price competition no longer occurs in the NHS, and the worry she’s talking about is void from the get go.

  7. Emil, Standard Oil springs to mind. I seem to remember that being broken up by the government.

    Microsoft? Water companies? Evening Standard?

  8. Luke, to take just one of those examples, the Evening Standard is only in a monopoly position (I don’t actually accept that it is, but for the sake of this post) because no other fucker wants to run a daily newspaper in London.

    Plenty have tried. It’s very expensive, it’s not very easy, and it’s increasingly not very profitable.

    But it’s an odd example, anyway. No-one has to pick up the Standard. A monopoly is only worth worrying about, insofar as people both have no choice as to whether they need the service offered and no choice as to the providers of those services.

    I’m personally sure that, left to its own devices, the market would sort out most monopolies anyway.

    I certainly don’t want the likes of Uncle Vince and Dave Cameron intervening, because all the obvious reasons.

    The biggest and most pernicious monopoly of all is that of the government.

    If someone can explain to me why they should have the monopoly on the criminal law (to take one example) from Cornwall to Carlisle I’d be interested in hearing it.

    I can’t see any reason why the people of Leicester, say, couldn’t or shouldn’t be alloweed to decide what is legal on in their city?

    If it works, and people prefer what’s being done there to what’s being offered in Nottingham, the latter will shrivel and Leicester will succeed.

    But no… that particular monopoly is sacred, and backed by threats of violence etc.

  9. Interested, there are plenty of goods and services people don’t “need” to buy, but that doesn’t mean you can’t have a monopoly over the supply of those goods and services to those who do want to buy (or pick up).

    ..”no other fucker wants to run a daily newspaper in London..” No, in part ‘cos the Standard has the (evening) market wrapped up. I suspect there is only room for one.

    Can I just add the Guardian as having a monopoly on advertising for government jobs?

    There aren’t that many monopolies, but one reason is that we have competition and anti-trust legislation/authorities.

    I can’t be bothered to discuss the monopoly of government. Sorry.

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