Doctors’ prescriptions for health care tend to conflict with economists’. In this essay, I take on the proposals made in The New Republic by Dr. Arnold S. Relman.

In a free market, consumer sovereignty and competition tend to create instability when sellers learn to game the system too well…

In a technocratic system, it is more difficult for consumers to exercise countervailing power. Innovative competitors are often precluded by regulation. Suppliers tend to apply concentrated lobbying power to protect their interests, while the diffuse interests of the consumer are poorly represented in the political process.

Centralized, regulated systems look good on paper, and they may be effective as they start. However, market systems learn faster, because competitive innovation prevents a market from getting captured by the incumbents who have learned how to game the system.

For Discussion. Relman believes that physicians would practice better medicine if they were insulated from market forces. Comment.