We live in an age in which personal accountability is a distant, unpracticed concept. It is taken for granted that every possible personal decision is open to socialization, and that any cost might be paid for by some distant other. People follow incentives, and when the incentives have been structured so as to eliminate the need for frugality, then waste and corruption inevitably follows. This is the rot that slays civilizations, and it will destroy the American empire just as surely as it did the British Empire and Rome.

We can see this corrosion underway most clearly in the centralized medical command and control infrastructures of the Western world. Unlike almost all other areas of technology, costs in medicine keep spiraling upward - and this should not be a surprise given the perverse incentives embedded in the system. Costs paid by other people. Services divorced from price considerations by the customer. Lack of competition. Use of regulators and the legalized bribery of lobbying to gain advantage in the marketplace, rather than research and development or price-cutting. And so forth.

But people know what they grew up with, and are exceedingly wary of change. Even when the long-established situation is terrible, as is the case for provision of medicine in most developed nations, the vast majority cannot see beyond its walls. So you'll find articles like this recent example, in which an presumably intelligent person argues that fixing the problems of socialized medicine requires the application of more socialism: more central command and control direction of economic behavior, more spending of other people's money, more separation between buyer, competition, and pricing.

There is a very simple solution to the problems of medicine. It's called freedom: freedom for providers to develop and compete as they see fit, and freedom for people to choose or reject their offerings with the money in their own pockets and savings accounts. For progress and efficiency to reign in an industry, people have to pay for goods with their own funds, and providers have to be free to innovate. Competition and the care with which people manage their own money keeps both sides as honest as any human culture is going to be.

Look at fashion. Shoes. Computers. DNA sequencing. Or any one of a thousand other important goods whose value has fallen over time and continues to do so. These are less regulated markets, not stifled and buried beneath chains like the provision of medicine. They are vibrant, constantly innovating and competing, and this is exactly because people pay for these products with the money they care about most.

If you want stagnation, terrible services, sanctioned cheating, and eventual collapse, then continue right on down the path forced on medical development and provision today: forcefully take people's money as taxes, throw it into a big pool, pay lip service to the proposed goals, and then watch the connected and the adept at bribery fight over claiming that loot for their own purposes. Every faction and individual is incentivized to take what they can grab, whilst trying to force other hands out of the purse. Pools of resources held in common are the death of charity: the sort of vicious infighting over a commons is anti-charity, the very polar opposite of charity in the spectrum of human behavior.

In short, government corrodes all it touches, and the rot has run deep in medical research, development, and commercialization. We all suffer for that, and will continue to do so until such time as revolution takes place to usher in a new age of honest competition and choice.