ABSTRACT
When government goes into public housing, it provides the actual apartments; when government goes into health, it can offer only medicine. But medicine is far from health. The government can try to equalize access to medicine, whether or not that access brings improved health. The simplest explanation is that insurance companies make no difference because they are embedded in the healthcare industry. The politics of medical care becomes a minus-sum game in which every institutional player leaves the table poorer than when he sat down. In the beginning, the number of new patients grows arithmetically while costs rise geometrically. Because the distribution of physicians is determined by rational choice — doctors locate where their psychic as well as economic income is highest — no special laws are needed to explain what happens. But the political pathology of health policy — the more the government spends on medicine, the less credit it gets — does require explanation.
