[...] And supporters of “free markets” don’t argue from morality anyway; they short-circuit any such soft-headed appeals by claiming with the sobriety of the realist that markets simply function better. Everyone knows the catechism: markets are the most efficient, predictable, and stable distribution system.

The economist Albert Hirschman calls this his discipline’s “reactionary thesis”: that any other attempt besides markets to organize distribution will fail. According to this thesis, non-market systems may have “all the theories of virtue,” but they only result in “all the consequences of vice.” Yet Titmuss’s account of the privatized segments of the American system demonstrated that it was not only morally debased. Compared to the British voluntary system, commercial markets in blood are less efficient (they lead to more lawsuits), more dangerous (they result in unsafe collection methods), and more wasteful (blood stores are not regulated by hospitals’ needs). Never mind idealism; markets aren’t always the best, fairest, and most efficient methods of distribution, as Americans in need of health care can these days discover for themselves.