Amerikaanse econoom legt uit waarom markt niet werkt in zorg

Amerikaans econoom en Nobelprijswinnaar Kenneth Arrow legt helder uit waarom marktwerking ongeschikt is voor de zorg: “Van een arts mag je verwachten dat hij het juist informeren van patiënten belangrijker vindt dan tevreden klanten.”

1. Concurrentie leidt tot slechtere informatiepositie van patient

Information held by insurers, doctors, and patients is always unequal. And, crucially, it’s expected that doctors’ concern for the correct conveying of information will, when appropriate, outweigh their desire to please their customers. In practice, the theoretical advantages of choice are outweighed by the fact that people don’t do a good job of making these choices in a competitive environment — it’s almost impossible. Competitive markets mean that information becomes commercial: we’re advertised to, not advised.

2. Veranderen van zorgaanbieder geeft slechtere kwaliteit van zorg

A competitive healthcare market is grounded in the expectation that some hospitals or surgeries will go bust. Instability is normal, so hospitals or GP surgeries will fold in the normal course of events. Such markets work well for groceries: if a supermarket closes you can get your carrots elsewhere. But healthcare isn’t a comparable transaction, he argued. Changes in professionals are deleterious to an ongoing relationship.
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