QUESTION: How do we stop the race to the bottom?
ANSWER:
Incentives have to change. Perhaps we can start with healthcare since there seems to be near unanimous agreement that this industry needs to be protected from the influences of capitalism. We need to prove that we can get the incentives right in one industry at a time, and then evolve those mechanisms into the next industry.
I believe that we need to think about the "leasing model" as a methodological foundation for how we combat the negative incentives of capitalism. When X person owns asset Y, they will want to maintain asset Y in a healthy state such that they minimize expenditures on Y. For a vehicle, person X will want to make sure that vehicle Y gets frequent oil changes so that they do not need a new engine. For a human, government X will want to make sure that patient Y gets frequent doctor checkups so that they do not need a new organ. What this means is that providers of services will need to become "owners" of the results of their service. Healthcare providers must deliver free healthcare to all patients. If checkups are infrequent (infrequent oil changes), the healthcare provider is responsible for the cost of all expensive procedures that derive from their negligence, as they own those results. So the only way for healthcare providers to maximize their revenue is to keep their patients as healthy as possible (prevention and root-cause amelioration) so as to avoid a never-ending stream of treating symptom after symptom (more costly).
For revenue purposes, patients could be clustered into "blocks". Health care providers will "own" the health of a "block" of people. The incomes of the people within this "block" are taxed and the health care provider receives a consistent percentage of revenue from the taxation on the block they are responsible for. If their block of people become unhealthy, sickly, brain foggy, and disabled, the income of the block will drop, and the revenue the health care provider takes in will drop. This will help align health care incentives with maximizing the health and productivity of their block.