The Mayo Clinic and the Free Market

Written By: Michael Accad  |  Posted: Friday, October 7th, 2011

             Neoclassical economists such as Kenneth Arrow and Joseph Stiglitz tell us that the healthcare market is imperfect (or "Pareto inefficient"), meaning that the allocation of services is not optimal from the standpoint of social welfare. They point to information asymmetry as an important cause of this imperfection: patients cannot distinguish on their own the physician from the charlatan, the surgeon from the butcher, the remedy from the snake oil, the hospital from the coop. This may lead to moral hazard where the party with the most knowledge can provide inferior service with impunity.

            To provide the necessary counterbalance for this "knowledge gap," experts must be in charge of social institutions that tell patients where to go, whom to see, how to be treated, and how much it should cost. This has been a principal and virtually unchallenged argument underpinning healthcare legislation for the last 100 years. In a famous paper he wrote on the subject in 1963, Arrow declared, "It is the general social consensus, clearly, that the laissez-faire solution for medicine is intolerable."

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