• Constant Tinkering

    Rudolf Klein with an interesting discussion of the most recent round of reforms in the NHS, and how there is nothing new under the sun in the constant tinkering with the health system.

    As an aside, reading this post took me back to when I was a post-doc at the University of Manchester (U.K.) in 1995-96, and got a chance to meet Dr. Klein on a trip to the University of Bath. He graciously talked with me about health policy and my research at the time. The discussion went to the role of culture in shaping what is politically feasible in terms of cost control. He made an observation comparing the U.S. and the U.K. along these lines: the U.K. is an original sin nation; they expect things to be bad and to likely get worse, be it the weather, waiting lists for knee replacements, or England’s chance of winning the World Cup. In the U.S., it is the opposite. We believe in the perfectability of humankind, and expect that with enough effort, money and energy, we should be able to fix anything.

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    • Great quote! We economists don’t usually point to culture as a first explanation, but it’s hard to escape the conclusion that the US is in a high expectations equilibrium and it will take some “discontinuous” shock to knock us away from it more than temporarily.