I think this is a good argument in general, but idk how it does against this particular set-up.
When spending levels are pegged, and you are starting out with a budget scope similar to current social programs, some particular company or bureaucracy is only going to capture a whole market if they do really good job since: A: people can opt-out for cash, B: people can chose different services within the system, and C: people can spend their own income on whatever they want outside the universal system.
As long as you sustain fitness pressure on the services, and constrain the competition to performance rather than anti-competitive capture maneuvers, I think it could go well.
Singapore’s health system comes to mind since it is a very low percentage of GDP, has both public and private options, and there is still universal care (though you always face some degree of cost when getting care in order to avoid bad rationing).
This sort of thing could go very poorly in practice if the government is too corrupt, but in that particular case it seems like there is sufficient fitness pressure on government hospitals from the private sector that they are probably doing a good job.
I think this is a good argument in general, but idk how it does against this particular set-up.
When spending levels are pegged, and you are starting out with a budget scope similar to current social programs, some particular company or bureaucracy is only going to capture a whole market if they do really good job since: A: people can opt-out for cash, B: people can chose different services within the system, and C: people can spend their own income on whatever they want outside the universal system.
As long as you sustain fitness pressure on the services, and constrain the competition to performance rather than anti-competitive capture maneuvers, I think it could go well.
Singapore’s health system comes to mind since it is a very low percentage of GDP, has both public and private options, and there is still universal care (though you always face some degree of cost when getting care in order to avoid bad rationing).
This sort of thing could go very poorly in practice if the government is too corrupt, but in that particular case it seems like there is sufficient fitness pressure on government hospitals from the private sector that they are probably doing a good job.