David Cameron’s detachment from NHS reforms means they are drifting

Free markets in healthcare don't work.

Patients and local doctors (GPs) are ignorant, and all private healthcare providers are charlatans. Simple fact: a profit maximizing business will lobby, market and sell its product as effectively as possible. Wherever there is legal room, competitive pressure forces such businesses to overstate/ exaggerate effectiveness of a treatment (this can be done suggestively, indirectly, with emotive case studies, etc; there is plenty of room to miss-sell without producing illegal false numbers).

No room for doubt: in the UK, look at the cosmetic industry. Look at "pro-biotic" yogurts. Look at homeopathy, religious healing and the other bunk.

In the states, commercial markets in healthcare, this level of charlatan deceit infiltrates even the largest pharmaceutical giants - they all market heavily for local physicians to prescribe their drugs over equally or more effective alternatives. Medical research groups over-egg the potential benefit of their treatments and procedures, resulting in health risk, billions of wasted dollars and millions of wasted hours.

For healthcare to work efficiently, there has to be robust empirical evidence for the relative merits of different treatments - new and old. This must be statistically and numerically analyzed, and all physicians should follow the resulting guidelines pretty closely.

The NHS is pretty good at all this, which is why - despite terrible under-investment and under-staffing - the UK has much higher life expectancy than the US at less than a quarter of the cost per citizen.

Change is needed - charlatans are not. Where the private sector is involved, health decisions should be centralized and empirical rather than based on marketing to local doctors and patients.

Amid falling budgets and growing demand, the NHS needs to alter radically if it is to maintain standards, let alone raise them. Voters still need to be convinced of that unwelcome truth.

The rest of your article explains why the Government's policy of radical change is already leading to lower standards, in the form of tighter rationing and longer waiting times. It's difficult to convince the Economist of that unwelcome truth.