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Based on his chapter from the book entitled, "The public/private mix for health," edited by Gordon McLachlan and Alan Maynards.

Inadequate understanding of the realities of the current health care system hampers the continuing debate between those favoring a "free market" approach & those supporting socialized medicine. Promarket arguments rely on an idealized, nonexistent market; antimarket arguments vaguely discuss "meeting reasonable needs," without providing a functional definition of these terms. Only an adequate grasp of the realities of the existing market -- taking into account the roles played by insurance, regulation & monopoly, & the cost, ineffectiveness, & allocation of resources characterizing present practice -- can lead to effective modification of health care provision. Greater attention should be paid to economic analysis of specific practices such as clinical procedures, screening & preventive programs, organization of health clinics & hospital departments, & large capital investments; behavioral modeling can also point to effective change. All of these tasks require the cooperation of economists & health care specialists, not a continuation of the ideological clash of pro- & antimarket forces. J. Weber.

SUMMARYThis paper utilises standard welfare economics to explore a number of assertions that are frequently encountered in connection with the economic rationale of the National Health Service (NHS). It is shown that the NHS‐type of delivery system is likely to produce neither a socially nor medically optimal amount of care, that it is unlikely to achieve consumption equality (even if private practice were to be abolished), that private practice does not enable an optimum to be reached (though some are enabled to make Pareto‐preferred moves) and that non‐price discrimination may systematically discriminate against the poor. A case is also made for the general validity of the choice‐theoretic approach to health care on the grounds that neither demand nor supply is as uniquely determined by technical considerations as is commonly supposed.