So you think having concept of providing a comprehensive service will ensure a better outcome? Surely any firm entering the market will look for the easy hits - knock out those cheap and easy ops and leave the nasty, lingering terminal cases to somebody else - pretty much like the Bupa type firms do. So how will you encourage firms to take the nasty, long winded, expensive to manage cases? Or will you just leave them to fend for themselves like in the US? You're surely going to have to pay a mbuttive premium to get establishments to take them on.
Yes - and that was my point - its my choice - I'm not being coerced into it - as many are in the private sector.
As I say - unless you're undergoing some sort of elective procedure - I don't want to shop around. If I have a heart attack, or a burst ulcer, or break my leg or my wife goes into premature labour - I'm not going to drive around 3 or 4 hospitals that might be 40 miles apart looking for the best deal - I'm going to the closest one - and I want that one to provide a decent quality of care for me. There is no "market" as such for this sort of healthcare, so the mechanism that you think will bring improvement simply won't work.
As mentioned below - education is a similar case - there is no market because nearly all schools are full to capacity (and there'd be an outcry if they weren't) - but it means there is no market mechanism - everyone tries to get their kids into the "best" local school - but once its full - thats it, the market is shut. What is required is to bring all schools up to a required standard, though the best way to do that is a moot point. Certainly leaving it to sort itself out leads to the better perceived schools able to select their intake and getting even "better" and the worst perceived in a downward spiral of decline as they get all the problem cases that can't find entry elsewhere.
You can't have it both ways - either it'll be the big firms consolidating the market - or a load of tiny ones.
See above - leaving it to the market will not solve the problem.
Surely this negates your argument - you say that improvement will only take place when people's jobs are on the line - but when consultants are hired, and then fired after proposing inappropriate solutions, nothing has been improved - in fact its demonstrably worse??
Well - we'll just have to differ on this stuff - we both believe what we believe and are unlikely to change our opinions in a forum such as this.
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