Privatize, privatize, privatize
I wonder how many times it must happen, before people start realizing that dysfunctional state monopolies cannot be blamed on single individuals, but that they are a result of perverse incentive structures coming from an unjust and impractical concentration of power.
The latest scandal in Sweden is the merger of two giant Stockholm hospitals into a single administrative unit. Karolinska and Huddinge, each with slightly less than 1000 hospital beds , are supposed to save money by being run together (although there is NO research to suggest that there are any economies of scale in healthcare beyond having 500 hospital beds per hospital). Recently, it has begun to dawn on people that the merger is a tad bit more complex than what was previously thought, and that it is not going all that well.
The biggest problems have occured in the cancer treatment unit, Radiumhemmet. The head of Radiumhemmet was sacked, officially because the quality of care has been faltering. However, it seems that the real reason was that he was deemed illoyal by top management. Last Saturday, two letters to the editor (here and here) appeared. The writers were two physicians who have worked for a long time at Karolinska and who argue that physicians and nurses have to take matters into their own hands, since the hospital management is putting patients in jeopardy.
In the meantime, the opposition in Landstinget, the political body who oversees the monopolized healthcare, is protesting. They claim, and rightly so, that they have warned against growing problems as the state colossus grows in size. They want a "crisis comission" to handle the problem and come up with a solution.
Well, what could a comission of this kind answer, that we don't already know? The problem with the monopoly on healthcare in Sweden is that the state is both purchaser (provides health insurance) and producer (owns and runs hospitals). No wonder that patients don't come first. Add to this the complete lack of management talent among politicians, and the short-sightedness coming from changing the political leadership every four years, and only one answer comes into mind: Privatize, privatize, privatize. For those who still want the state to cover healthcare costs, there is always the possibility of a voucher system. Or tax deductions for health insurance. A healthcare unit, like any other organization engaging in production, will not work well if it is both buyer and supplier.
But alas, I doubt that change is near. An ideological blindfold covers the eyes of leading social democrats, who are also hungry for the power coming from controlling peoples lives. And they have taxed Swedes to the point where only the really rich can afford supplementary health insurance. Thus, private healthcare in Sweden can be framed as a class issue. Instead, Swedish physicians and nurses will have to continue to live in a system that, according to the letter sent in last Saturday, bears close resemblence to communism:
Be loyal to the hand that feeds you, i.e. the state.
The latest scandal in Sweden is the merger of two giant Stockholm hospitals into a single administrative unit. Karolinska and Huddinge, each with slightly less than 1000 hospital beds , are supposed to save money by being run together (although there is NO research to suggest that there are any economies of scale in healthcare beyond having 500 hospital beds per hospital). Recently, it has begun to dawn on people that the merger is a tad bit more complex than what was previously thought, and that it is not going all that well.
The biggest problems have occured in the cancer treatment unit, Radiumhemmet. The head of Radiumhemmet was sacked, officially because the quality of care has been faltering. However, it seems that the real reason was that he was deemed illoyal by top management. Last Saturday, two letters to the editor (here and here) appeared. The writers were two physicians who have worked for a long time at Karolinska and who argue that physicians and nurses have to take matters into their own hands, since the hospital management is putting patients in jeopardy.
In the meantime, the opposition in Landstinget, the political body who oversees the monopolized healthcare, is protesting. They claim, and rightly so, that they have warned against growing problems as the state colossus grows in size. They want a "crisis comission" to handle the problem and come up with a solution.
Well, what could a comission of this kind answer, that we don't already know? The problem with the monopoly on healthcare in Sweden is that the state is both purchaser (provides health insurance) and producer (owns and runs hospitals). No wonder that patients don't come first. Add to this the complete lack of management talent among politicians, and the short-sightedness coming from changing the political leadership every four years, and only one answer comes into mind: Privatize, privatize, privatize. For those who still want the state to cover healthcare costs, there is always the possibility of a voucher system. Or tax deductions for health insurance. A healthcare unit, like any other organization engaging in production, will not work well if it is both buyer and supplier.
But alas, I doubt that change is near. An ideological blindfold covers the eyes of leading social democrats, who are also hungry for the power coming from controlling peoples lives. And they have taxed Swedes to the point where only the really rich can afford supplementary health insurance. Thus, private healthcare in Sweden can be framed as a class issue. Instead, Swedish physicians and nurses will have to continue to live in a system that, according to the letter sent in last Saturday, bears close resemblence to communism:
Be loyal to the hand that feeds you, i.e. the state.
posted by Hugin at 20:15
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