Most people resist changing their habits. And that includes harassed and exhausted Israelis. This change avoidance might explain the success of vested interests in preserving the status quo in our ailing health system.

It’s a system that is perpetually on the verge of bankruptcy, causes unnecessary suffering to countless people and may even have contributed to medically avoidable hospital deaths.

We are simply used to living with a system that periodically faces collapse, like during the current flu epidemic.

Another factor militating against true health care reform is that public discourse is dominated by an assortment of lobbyists, social do-gooders and vested interests, including powerful health care unions, the physicians’ association and the drug industry.

Ignoring the huge resources the system is presently wasting, or the fact that it breeds inefficiency and even corruption, lobbyists always offer a simple solution to the problems confronting the medical system: Spend more.

It matters not that such a costly prescription, though repeatedly administered in exponentially more costly doses, has failed to cure our ailing health system, and probably made it far more sickly.

The reason for the failure of practically all socialized medical systems is embarrassingly simple.

“The only relevant question about a health system,” Nobel Laureate Milton Friedman wrote in Free To Choose, back in the 1970s, “is whether the client pays for the costs of medical services directly,” thus being able to demand from their providers a good and reasonably priced product, “or indirectly, through bureaucratic government intermediaries that use a large parts of his payments for their own salaries and expenses,” and whose role absolves the providers from accountability to the patient.

In a socialized system the patient has no leverage whatsoever on the providers since patients are unable to withdraw their patronage or payments.

We need to expose the fiction that you can get unlimited, high-quality medical care on the cheap. People need to see the true connection – including the many concealed costs – between what they pay and what they get.

Left unexposed, there are no incentives for good performance; waste and corruption remain encouraged.

PATIENTS MUST be free to choose among medical providers and to purchase supplemental insurance as they see fit.

This does not contradict the need to provide basic medical care in an egalitarian and efficient manner.

All citizens should be required to purchase an agreed-upon medical policy. Those who cannot afford it should be helped by government. But insurance providers should be separated from service providers – doctors, clinics and hospitals – forcing them to compete for clients.

Public health systems all over the world are in trouble because, pursuing the chimera of perfect equality, they have nationalized health care delivery or adopted other failed socialist policies.

Why imagine that what failed in all other sectors will somehow succeed in the much more difficult health market?

Until not long ago we excused the failure of our socialized health care system by arguing that it had not yet achieved the maturity of the British system, which works perfectly. When we discovered the truth about the failing British system we projected our utopian beliefs on Canada. But gradually we learned that Canada also was no exception.

Even the relatively capitalistic United States has serious health care problems. A recently published review by the Heritage Foundation quotes Winston Churchill, who observed that “Americans can always be counted upon to do the right thing, after all other possibilities have been exhausted.”

The Heritage study observes: “For decades we have tried everything else. We have tried wage and price controls, centralized planning, government programs of every stripe, uncountable rules and regulations,” all in an effort to provide reasonably priced health care.

All these efforts failed.

“Only now are we getting around to the idea that works so well in every other part of our economy – allowing individual consumers to spend their money on the services they value most.” It’s that simple.

This is an argument I first made in a 1988 op-ed published in Yediot Aharonot in connection with a commission of enquiry appointed to study an earlier health crisis.

That essay was entitled “Our health system needs a psychiatrist rather than an investigation” and I argued that “it is well known what has to be done, yet none dare do it despite the huge costs in resources and in human suffering and life that our failed health care system exacts. If we can indeed have a better, less costly system and we avoid building it, is that not madness?”

Seventeen years on, our health care system still needs psychiatric intervention.

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