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The other side of that coin is, with quality as the main motivator, the prices go up. There's no free ride either way through organising things differently, its

The other side of that coin is, with quality as the main motivator, the prices go up. There's no free ride either way through organising things differently, its a choice between quality or price (as opposed to getting quality at a cheaper price). The other issue of course is in a public setting, there is no motive for efficiency.

eigenket 3y ago
> Since then the sector has accumulated £53bn in debt while distributing £72bn to shareholders, the majority of whom are international investors Theres actually a pretty huge amount of "free ride" sitting there waiting to be ridden.
- neximo64 3y ago
  One of the assumptions that may be being made in this statement is funds can be borrowed for free, in a debt or equity setting. Whoever is lending/providing those funds does expect something in return. Even a government that borrows, needs to pay something back with interest. And an investment by the way of shares the government makes needs something back roughly matching the interest rate too. I don't really see an argument where a public setting is any more beneficial from what you're saying, if the international investor was the the treasury, it would still want something back by shareholder returns.
vidarh 3y ago
A counter: The NHS is one of the cheapest universal healthcare systems among comparable developed countries. It's run on an utter shoestring. In other words: You can set budgets and force your providers to do the best they can within them. No matter where you set them, people will be unhappy, but it's not like setting quality as the main motivator means you need to give the provider free reign to spend however much it wants. PPP adjusted total UK healthcare spending is less than half of the US, despite a significant private sector acting as an outlet for a proportion of the situations when people are unhappy with the NHS. Incidentally US public money per capita going towards healthcare exceeds the per capita cost of the NHS (whether nominal or PPP adjusted). The low amounts flowing to private providers in the UK can be seen as a demonstration that most people considers the NHS service good enough - while many would not be able to afford going private, the proportion who could if it mattered is certainly far higher than the current takeup.
tnel77 3y ago
Assuming quality does actually go up, prices going up aren’t the worst thing ever. I would just want the utility to have programs for low-income households since we don’t want to price people out of a necessity.

eigenket 3y ago

> Since then the sector has accumulated £53bn in debt while distributing £72bn to shareholders, the majority of whom are international investors Theres actually a pretty huge amount of "free ride" sitting there waiting to be ridden.

neximo64 3y ago
One of the assumptions that may be being made in this statement is funds can be borrowed for free, in a debt or equity setting. Whoever is lending/providing those funds does expect something in return. Even a government that borrows, needs to pay something back with interest. And an investment by the way of shares the government makes needs something back roughly matching the interest rate too. I don't really see an argument where a public setting is any more beneficial from what you're saying, if the international investor was the the treasury, it would still want something back by shareholder returns.

vidarh 3y ago

A counter: The NHS is one of the cheapest universal healthcare systems among comparable developed countries. It's run on an utter shoestring. In other words: You can set budgets and force your providers to do the best they can within them. No matter where you set them, people will be unhappy, but it's not like setting quality as the main motivator means you need to give the provider free reign to spend however much it wants. PPP adjusted total UK healthcare spending is less than half of the US, despite a significant private sector acting as an outlet for a proportion of the situations when people are unhappy with the NHS. Incidentally US public money per capita going towards healthcare exceeds the per capita cost of the NHS (whether nominal or PPP adjusted). The low amounts flowing to private providers in the UK can be seen as a demonstration that most people considers the NHS service good enough - while many would not be able to afford going private, the proportion who could if it mattered is certainly far higher than the current takeup.

tnel77 3y ago

Assuming quality does actually go up, prices going up aren’t the worst thing ever. I would just want the utility to have programs for low-income households since we don’t want to price people out of a necessity.