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Will a market deliver quality and efficiency in health care better than central planning ever could? Yes

BMJ 2010; 340 doi: (Published 10 March 2010) Cite this as: BMJ 2010;340:c1299
  1. Stephen Smith, principal
  1. 1Imperial College Faculty of Medicine, London SW7 2AZ
  1. s.k.smith{at}

    James Gubb (doi:10.1136/bmj.c1297) and Stephen Smith are convinced that market forces will improve the NHS, but Neal Lawson (doi:10.1136/bmj.c1300) and Jonathon Tomlinson (doi:10.1136/bmj.c1302) have their doubts

    Markets already exist in health care, working to deliver innovation alongside quality and efficiency. They exist at many levels—between competing individuals, systems, and organisations, both public and private. Although many of these markets successfully deliver and innovate, such as those in medical devices and drugs that generate a substantial proportion of the UK gross domestic product, several of the existing markets are imperfect.

    Adam Smith said that a perfect market exists where there …

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