When more patients is a good thing

Flicking recently through the list of members of the Kebyar Network, an organisation promoting organic architecture, I stumbled across the website of an architect who specialises in designing medical clinics and hospital emergency rooms. His website boasted that his company's emergency rooms have proven more successful in attracting customers than any others.

I was struck by that. Struck by the contrast with how a designer of hospitals in New Zealand or the UK would promote themselves. Struck by the contrast in incentives between 'public' and private medicine. When this guy is hired by profit-making businesses to design their emergency rooms, his clients actually want him to attract more people inside. In their view, attracting more customers is a good thing, since more customers equals greater profits, and and increased ability to treat even more patients.

Such are the incentives in private medicine.

By contrast, when the government builds emergency rooms, more people are a nuisance. More patients equals an increasing strain on limited resources. More people in the emergency room is a problem.

Such are the disincentives in state-run medicine.

Where increased custom in the private emergency rooms designed by my colleague is a good thing -- it's an opportunity for growth and profit -- increased custom in the state's die-while-you-wait health system is a problem that's so bad on Auckland's North Shore it's being ameliorated by using ambulances instead of hospital beds to take up the shortfall, even as a man who was throwing up blood had to wait a whole three hours to get simply get to the hospital because the ambulance were busy and hospital was already full.

Welcome to socialist medicine.