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South Africa’s healthcare under threat 45how many hospitals and beds there should be, where they shouldbe located, the type and quantity of services and medicines that willbe available, the salaries health-care professionals may earn, theamount of money that may be spent on particular procedures andtechnologies, the type of equipment that may be installed at hospitalsand clinics, and the prices that will be charged for health-careprocedures and medicines.South Africa’s new National Health Act subjects its privatehealth-care providers to the same controls applied in a socialisedhealth system. Private care, from now on, will thus be private onlyinsofar as health establishments will be privately owned. The governmentwill be planning the entire health-care system, with direconsequences for all patients, rich and poor.A government attempting to plan and/or provide health care to anentire nation is confronted by the insurmountable obstacles faced bycentrally planned and co-ordinated systems: the impossibility ofknowing everything necessary to ensure effective, efficient andequitable delivery of goods and services, the ignoring or obliterationof signals provided by prices, the complexity of centralisedplanning, the difficulty of forecasting the future, and the inefficiencyof governments in general.Centrally prohibited health careWhen governments impose plans on their citizens, whatever doesnot fit in with those plans becomes illegal. This observation lead theeconomist Murray N Rothbard to remark that a centrally plannedeconomy is a centrally prohibited economy (Rothhard, 2004).Socialised care becomes government-prohibited health care:nothing may be done without prior government approval. So, forexample, South African doctors will be prohibited from openingmedical practices in areas that government health-care plannersbelieve are adequately served. The planners will somehow knowexactly where all doctors should practise and what procedures andequipment they should use in order to meet the needs of allpatients.