Counterrevolutionary Meditations

Via Parapundit, a report on the release of an interesting Harvard Medical School report on the relative performance of for-profit and non-profit hospitals in the delivery of critical, high-quality medical care:

BOSTON-December 11, 2006 - Patients are more likely to receive high quality of care in not-for-profit hospitals and in hospitals with more registered nurses and advanced technology, reports a comprehensive Harvard Medical School (HMS) analysis published in the Dec. 11 Archives of Internal Medicine.

Such a conclusion cannot but seem counterintuitive to those subjected to high-level doses of market propaganda, to the effect that the profit motive is the only, or the most, efficient means by which resources may be allocated, and information transmitted through the billions of nerve-fibers (consumer decisions) of the free economy. Parapundit comments:

Anyone surprised? I'm not. Quality of care is hard for patients to measure. So the market is not very good at rewarding those who deliver higher quality care. The profit motive is not sufficiently well disciplined by the market in the medical marketplace.

I would suggest that this market failure is perhaps inherent in the structure of for-profit hospitals, inasmuch as optimal care is almost uniformly more costly, which entails that administrators of such institutions have an interest in, well, doling out care of the highest quality with some degree of parsimony. Which broaches the more compelling question of the limits of 'spontaneous' systems of order and exchange, and the degree to which such systems may in fact be artifactual in nature: that is, islands of controlled 'chaos' embedded within larger, ordered social systems. Come to think of it, that neatly expresses the proper relationship of the 'economy' and 'society', of which the economy of market exchanges is but one aspect, and that a partial and underdetermining aspect, society itself being greater than both the sum total of individual preferences and the aggregate of economic transactions.