Kenneth Arrow om vinstdrivande privata vårdföretag

18 Nov, 2011 at 10:17 | Posted in Economics | Comments Off on Kenneth Arrow om vinstdrivande privata vårdföretag

Under de senaste veckorna har mycket i media handlat om vinstdrivande företag inom vård- och skolsektorn. Det tycker jag är bra. Den diskussionen behövs.

Mindre imponerande var väl då Håkan Juholt, som – inte minst mot bakgrund av skandaler runt Carema – borde haft  ett gyllene tillfälle att klart och tydligt tala om att socialdemokratin nu vill se till att undanröja möjligheterna för vinstdrivande bolag att verka inom vård, omsorg och skola. 

Men så blev det inte. Juholt svajade  istället.

Ingen borde svaja i denna fråga, speciellt inte efter att ha läst följande stycke, skrivet av den kanske främste nu levande nationalekonomen i världen, nobelpristagaren i ekonomi år 1972, Kenneth Arrow,  som i ett klassiskt arbete om vårdsektorns ekonomi redan år 1963 skrev följande visa ord:

Under ideal insurance the patient would actually have no concern with the informational inequality between himself and the physician, since he would only be paying by results anyway, and his utility position would in fact be thoroughly guaranteed. In its absence he wants to have some guarantee that at leats the physician is using his knowledge to the best advantage. This leads to the setting up of a relationship of trust and confidence, one which the physician has a social obligation to live up to … The social obligation for best practice is part of the commodity the physician sells, even though it is a part that is not subject to thorough inspection by the buyer.

One consequence of such trust relations is that the physician cannot act, or at least appear to act, as if  he is maximizing his income at every moment of time. As a signal to the buyer of his intentions to act  as thoroughly in the buyer’s  behalf as possible, the physician avoids the obvious stigmata of profit-maximizing … The very word, ‘profit’ is a signal that denies the trust relation.

Kenneth Arrow, “Uncertainty and the Welfare Economics of Medical Care”. American Economic Review, 53 (5).

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