Socialist Planning Doesn’t Work?

What About Healthcare?

Healthcare is perhaps the clearest case for the success of rational economic planning over private markets. (this image was generated using OpenAI’s DALL-E, a model trained to create images from text descriptions).

Everyone knows the U.S. healthcare system is broken. It costs more than any other in the developed world, yet leaves tens of millions underinsured or uninsured. Outcomes are average at best, and administrative complexity is a nightmare. Interestingly, the U.S. system is the only one in the developed world that is private and market-driven. In that, it gives us the perfect basis for comparing socialist planning versus private market systems between otherwise comparable countries.

Look across the developed world: France, Germany, the UK, Scandinavia. These countries run healthcare systems that are either state-run, heavily regulated, or based on solidarity models. They spend less, cover more people, and achieve better outcomes—higher life expectancy, lower infant mortality, greater patient satisfaction. These systems aren’t anomalies. They’re the norm in rich, democratic societies.

Importantly, it’s not merely that these systems are more just because they grant equal access. The point is that classic economic indicators—like cost-efficiency, outcome quality, and customer satisfaction—all favor what are, in essence, socialist-planned systems. And that’s exactly for the reasons classic socialist thinkers gave when arguing for the necessity of rational planning or comprehensive industrial policy—not to be confused with undemocratic Soviet-style command economies. Economies of scale and scope, combined with a system designed to provide services rather than generate profit, work better for the many than private market logic does.

Indeed, it’s hard to see why this should only be true for healthcare. The liberal distinction between public services and private business is mostly artificial. Healthcare is not fundamentally different from other economic sectors. It has suppliers and consumers, infrastructure, logistics, and labor, just like transport, housing, or manufacturing. It involves cost, coordination, and scale.

The only reason we speak of healthcare as a “special case” is because the negative results of markets are so stark. But this doesn’t mean it’s different in kind—only that it makes the failures of market logic harder to ignore.

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© 2025 Alexander Jeuk for the text. For the image see the caption.