Editor's Choice: Why markets don’t work in healthcare

...Their nightmare scenario, unspoken in this article but clearly haunting it, is American healthcare. In our first BMJ Essay published this week, Arnold Relman gives his own no-holds barred account of the US system (doi:10.1136/bmj.e3052). How, he asks, does the US system manage to spend twice as much as some other countries and yet achieve, on average, much worse outcomes? His answer: "the US alone among advanced Western countries has allowed its healthcare system to become a market and its physicians to behave as if they were in business."
Pollock and colleagues offer no solution to the problem they identify. Relman does: private but non-profit multidisciplinary groups of salaried physicians, paid for by a single public plan providing universal access to comprehensive care. It sounds familiar. But he thinks the US will have to go bankrupt first.
Fiona Godlee, editor, BMJ
Cite this as: BMJ 2012;344:e3300