Y el mercado también funciona para un sistema de salud eficiente

Hoy, en Café Hayek, Don Boudreaux rescata una cita espléndida de James Buchanan para explicar, a los intelectualmente miopes, que aún en asuntos complejos como el sistema de salud en Estados Unidos que padece serias deficiencias, la solución son los mecanismos de mercado, en lugar de pontificar " a priori", y sin demostración alguna, que para cosas tan importantes los mercados no funcionan, que es lo que pontifica, entre otros, Paul Krugman.

Todo ello, alrededor de la discusión pública acerca de la reforma integral del sistema de salud en Estados Unidos que hoy es notoriamente caro e ineficiente. Reforma que, por cierto, se ha vuelto casi una obsesión para el presidente Barack Obama.

Vale la pena leer el sólido alegato de Boudreaux en este vínculo. ("Markets don't work in health care?").

Por otra parte, y para reforzar el comentario anterior sobre la venta de casas en Estados Unidos, va la cita de Buchanan en inglés, para no arriesgarme a las inexactitudes producto de una traducción apresurada:

The motivation for individuals to engage in trade, the source of the propensity [to "truck, barter and exchange" - Adam Smith (1776)], is surely that of "efficiency," defined in the personal sense of moving from less preferred to more preferred positions, and doing so under mutually acceptable terms. An "inefficient" institution, one that produces largely "inefficient" results, cannot, by the nature of man, survive until and unless coercion is introduced to prevent the emergence of alternative arrangements.

Let me illustrate this point and, at the same time, indicate the extension of the approach I am suggesting by referring to a familiar and simple example. Suppose that the local swamp requires draining to eliminate or reduce mosquito breeding. Let us postulate that no single citizen in the community has sufficient incentive to finance the full costs of this essentially indivisible operation. Defined in the orthodox, narrow way, the "market" fails; bilateral behavior of buyers and sellers does not remove the nuisance. "Inefficiency" presumably results. This is, however, surely an overly restricted conception of market behavior. If the market institutions, defined so narrowly, will not work, they will not meet individual objectives. Individual citizens will be led, because of the same propensity, to search voluntarily for more inclusive trading or exchange arrangements. A more complex institution may emerge to drain the swamp. The task of the economist includes the study of all such cooperative trading arrangements which become merely extensions of markets more restrictively defined.