Do you (happily) expect less from the government?

Great Debates
1

There have been many threads on transforming the US healthcare system to a single payer / nationalized system. Could this make people happier by simply lowering the expectations?

When I renew my driver’s license I expect the worst. I fully intend to spend most of the day trying to achieve a relatively simple task. When I finally finish and leave the soul crushing people’s paradise building in less than an hour, I am simply over the moon with joy. That wasn’t so bad.

When I ride the city buses or trains, I’m ok with a weak schedule. Some trains come others don’t. Sometimes the doors open, sometimes I run to another car. Sometimes the place is packed, sometimes the soiled wino is the only other living creature. Compare that to expectations on private buses, airlines and taxis. I expect more from private companies. But I am happier with the public transportation. The service on public transportation is better than I expect while the service from private companies is usually lower. The private business still offer an objectively better service but I tend to be disappointed.

Listening to friends and relatives in the teaching profession, it seems that the parents in private schools get angrier quicker. Do they expect such higher results for the tuition that the overall experience might be worse?

When I call my insurance company and get an infuriating phone tree, I am enraged. Why won’t they just answer the damn phone? When I call a similarly impersonal government office, I’m often disconnected. I laugh a bit at the total incompetence and try again.

If I am not the only one like this, could this help in public policy? Could we be happier with a nationalized (but possibly worse) system? After the initial adjustment, would we be happier going to a government clinic and waiting three hours than we are now going to a private clinic and waiting one hour? Clearly, those without access now would be happier and healthier. I wonder if the average person with existing access might be happier.

Have any of you noticed this in your own lives?

2

You know what? I think this has potential.

Moved from IMHO to GD.

3

I don’t think it applies across the board. There are always instances where the government occasionally does better than a private service. For example, I’ve had boatloads of trouble with some private health insurance claims, but my mom’s never had any similar problems with Medicare (or with her Social Security payments). I got a better and faster response on a parcel trace with the Postal Service than my friend got on a similar query to UPS. Oh, and I got better customer service on an inquiry to a state Transit Authority than I did on the same inquiry to a private bus company.

I also don’t think it’s necessarily a given that people have to have low expectations of government service. The public transit system here in the Netherlands is outstanding compared to its American counterpart, but Dutch people sure don’t seem to have any qualms about bitching about it when it screws up.

4

You should understand that many of the proposals for a single-payer solution do not involve replacing private clinics with government ones. Instead, doctors and hospitals would continue to be privately owned, but they wouldn’t need the staff necessary to negotiate payment from various insurance companies (which also have staff necessary to process and deny payments). I’ve heard the estimate (sorry, no cite) that 25% of healthcare expenditures goes to these costs.

5

Well, I would say that I am not convinced that one would not be able to purchase higher quality care even if the government provided access universally at a basic level.

I think the REAL issue here is that it would singularly crush the insurance industry, not a diminishment in health care for those who have the money to pay higher rates for better care.

Insurance is an integral part of our social fabric, and undoing that would change everything and could cause social turmoil. So people formulate arguments talking about inferior care. They point to Canada as an example, but from what I hear Israel has socialized medicine and care there is BETTER on average here in America. Of course we have the luxury of an immense, wealthy populace, and a higher level of overall technological advancement than any other country in the world, all of which leading to the ability to provide some of the top specialists in any field. Not only that but we attract good doctors from around the world because we can pay them higher wages. However, as the economies in the rest of the world catch up with ours, that’s going to change anyway.

Erek

6

I agree with you about expecting less from government agencies. That has been my experience as well.

The difference with healthcare though, is that it may literally mean the difference between life and death of my loved one. In that situation I would not be happy knowing I was receiving less that what was needed, less than what had been once available to me.

When someone’s child is sick, there is no way they will feel good about having to wait three hours, instead of one. Sometimes that can be the difference of life and death.

7

I know that the service is sometimes better better with public than private but when I think about good service and bad service, It really sticks with me that FedEx lost a package. I’d expect it with USPS but not FedEx. Because of that, I remember when FedEx lost the package because I was far more upset.

I’ve been pleased with public transporation nearly everywhere I’ve been. Interestingly, I have the warmest memories of the buses in LA because I had heard such awful things. When I rode them for the first time I was impressed. Being “ok” was so much better than awful that I still think of them as a great public transportation experience. Sure German trains are clean and on time but that’s just expected.

My thoughts are more about what people expect and whether the lower expectations may work to a social benefit.

8

I think you’re right on the concept – I had the same experience when planning to take my car through inspection. It used to take hours, so last time I left really early, prepared with a cup of coffee, newspaper, etc… When I just whisked through in 5 minutes I was shocked and incredibly pleased.

As far as comparing public and private enterprise: My most recent experiences have often been that the gummint is at least as good and sometimes better. My dealings with the unemployment office could hardly have been better. For example, I was able to apply on line. The following week when I went to report (on line again) the partial salary payment I’d received from my former employer for my final couple of days, I ran into a snag of some sort. I called the UI office, and the person there tried to talk me through it. When I started getting server errors, she just said, “Oh, never mind. Just tell me what the numbers are and I’ll take care of it.” And she did. TOH, my former employer has not actually IMHO lived up to the letter of our agreement, but when I called to inquire about a payment, I got: put on hold, passed about from person to person, and promised a call back that I never received. I called back again and got an argument.

In this case, my former employer doesn’t care a whit if I am happy with them or not. The public servant, OTOH, can get in trouble if she has to call her supervisor. If there is one thing a public sector supervisor does NOT want it is to get called to the phone or from out of his/her office to the front desk.

9

I don’t think this is a good comparison, in that while the USPS is governmental, it is also run like a business in the sense that 1) it is required to pay for itself – balance its budget with minimal funding from Congress, and 2) its efficiency is partly a result of the fact that it does have private competition.

10

I think this gets to the heart of what I am wondering. If you take your daughter into the clinic with a broken leg, you probably expect to wait an hour. You don’t expect a medivac ride to the Mayo clinic. You’re not unreasonable. An hour is reasonable (this isn’t a compound fracture). If the wait goes to two hours, you’d start to get angry.

What if the system then changed. You hear horor stories about the new system. The TV ads were bad when the legislation went through. Your friends and family tell you the waits have gotten longer. If at that point your daughter breaks her other leg, you’d head to the same clinic maybe expecting a three hour wait. If you get in in two hours, you’re pleased. The service is the same but you might be happier.

This is counterintuitive. I wonder what others think of this.

11

The OP is the exact opposite of my experience and beliefs.

I expect, and get, better service from government entities than private companies. After all, private companies are always understaffed, cutting corners and skimping on service in order to maximize profits, an extra burden not carried by government. Governmnent agencies are accountable directly and solely for their service and efficiency. It’s their sole mission.

The tax agency here actually displays prominent posters advertising their customer service commitment. They promise - no, guarantee - quick, knowledgeable service. To fix obvious errors on the spot. Etc.

When I call the tax agency with some tax question, the phone is answered within a few rings. No menus. No transfers. The guy or gal who answers the phone, deals with my question. I mention my registration number, ask my question, and get the answer. Occasionally, they have to ask somebody else. In those cases, they call me back in 5 minutes. This has been my consistent experience for the past six years.

When I registered my company, there was a minor issue with my registration forms. So the guy handling the application called me, we discussed the matter on the phone, and reached a satisfactory conclusion. No paperwork back-and-forth, no red tape, no delay, no fuss.

Government around here were among the first to take their service to the Internet. I do all my tax paperwork on the Internet. For free. All the forms are there, they have calculators, you can read all the rules and regulations, etc. Their Internet service is still better than most private companies’.

Compare this with the “service” I get from my ISP, cable company, bank… nuff said.

So, my experience, and my frame of reference, is the exact opposite of the OP. Obviously, I am familiar with the attitude described in the OP. I tend to think it is typically American. Although surely there are many countries that still suffer from bad government. I wish more people would demand better from their government so that good government would be more widespread.

12

I get… something from the government for medical care?

Huh. News to me. I pay taxes, but I don’t get jack.