Serving customers and taxpayers

The welfare interests of the disadvantaged and chronically ill are not incompatible with the interests the taxpayers have for an efficient health care system. Efficiency in health care means meeting the needs of the customer at the lowest possible cost to both customers and taxpayers. Experience, not ideology, informs us that the incentives for efficiency are stronger in competitive private enterprise than they are in public sector monopolies. Our task is to try to harness these forces wherever we can, if not by private sector provision then by the design of alternative incentive mechanisms for the public sector.