Governments, in the sense of a something that rules over a territory, are not immortal - radical changes have regularly happened over history. But they’re as close to being so as anything we have in a human society. This leads some to conclude that government should be planning the long term things because that institution is the only one that faces the correct long term incentives.

The more rational among us note that while this could be conceptually true that might not be quite the way it works out:

Andy Cowper of Health Policy Insight points to the decision in 2006 to fix a short-term funding crisis by slashing training budgets, which contributed to staff shortages that still plague the NHS.

Government is run by politics, which means politicians. Whose time horizons never do extend to further than the next election - at that time some 4 years away. At which point they take a decision about a 7 year (minimum, for doctors) process with 50 year implications on the basis of rather shorter term considerations than either of those.

We’re not going to drop the democracy bit so the short term pressures aren’t going to go away. We’re left, instead, with the obvious truth that we can’t trust the government process to do the long term planning so we shouldn’t ask it to.

Which does, helpfully, get rid of a lot of the things that governments cock up and always will, for as we know, incentives matter. Taking long term decisions for short term reasons is just never going to work out well, is it?