Health Care and Basic Education
There are differences between health care and education. With regard to evidence-based research, health care is miles ahead of education. Reforms in education continue to be implemented without supporting data and studies remain poorly designed, without proper controls. On the other hand, the practice of medicine has been faithful to clinical trials and data. Health care, however, does not do well in terms of equal access. A public option, for example, in the richest country in the world, the United States, does not exist. But public schools still do.
The question that Baumol asks in the article is: Should these services remain in the public sector or should they be privatized? Current situations perhaps can answer this question. Health care is privatized in so many places. Excellent health care is available, but surely, not for everyone. Similarly, there are excellent schools that are both private and exclusive. These schools are, of course, not for every child. Privatization always tends to provide excellence first before access. Thus, there is that tempting conclusion that if quality is desired, one should privatize. To take the other option, that is, to continue with the public sector or government to provide or run these services, is then equated to low quality and inefficiency. Finland shows clearly that this is not the case. There are no private schools in Finland. Finland emphasizes equality and yet, Finland is in the top in terms of quality basic education. Excellence therefore can come with equality. When basic education is not seen as a vehicle to get ahead in life, better learning outcomes are achieved. Providing health care and basic education, without doubt, are different from making automobiles. The health and education of the members of the society are comparable to security, peace and order. I do not think societies have ever explored on a large scale the privatization of its police force or firefighters. I wonder why....