Yes, Sam Stone certainly posted some interesting things which seem to be at odds with the facts on the ground.
I wonder if he also thinks that electricians are at risk of losing their freedom to choose the standard of wiring that they will put into a building. “Those stinking socialist building codes! I want the freedom to wire this building however I like!”
Why would we want to eliminate Social Security and Medicare? They were designed to help old people who ,after their working days are over, to get food and health care without dropping the cost on their families. We saw far too many aged people suffering and decided to act . It was a compassionate and proper thing to do. It was well funded, if the pols could keep their mitts off the money. They did not, but that does not make the program less needed or less proper.
The mail has been delivered by the government since early days. When Fed Ex and other companies came in, they went after the packaging delivery. That was the profitable part of the post office and helped fund mail delivery.
Medicare provides health care to those who are most likely to cost money, the aged, the very same one health companies cancel policies on. Corporations do not want to compete. They want to cherry pick the best demographics and dump the rest on tax payers. Then they pretend they are actually operating more efficiently, while they are culling through the rest to dump more who might be less profitable. That is not competition . That is corporate self interest, with no consideration for the country.
Health Insurance Companies have proven they can not compete. They waste too much and charge too damn much. They eat 30 percent of the budget in management and exec salaries. They are what is wrong with American health care.
I’d vote for you.
I would encourage you to think a bit more broadly about how private sector companies can provide ‘safety’ relative to the public sector.
Three main points come to mind:
The ‘profit vs. safety’ tradeoff is IMHO overly simplistic. It assumes all other variables: incentives, costs, quality, competence, etc. remain constant in both worlds (public vs private) and everything boils down to the dual variable tradeoff of profit vs. safety. But many, many other variables change when moving from public operation to competitive private bid…so many, in fact, that they swamp the ‘profit vs safety’ tradeoff.
Private companies, in a competitive market, are incented to win the business and make money.
Successful private companies use their profits to reinvest in their people, their equipment and their processes to win more business. Profits allow for more investment in safety enhancing measures (research, materials, design) if that is what is important to its customer…you. A public contract can specify certain levels of important safety measures and stipulate that private companies meet those standards. In a competitive market, private companies would be incented to beat those measures to win business, if that was important to their customer.
Those incentives are lacking in a public enterprise. What incentive is there for a public works agency to get better at safety? If they have a fixed budget, what is the incentive to trade off hiring more unionized workers, for example, vs. investing in safety R&D? There are none.
They don’t need to worry about becoming more efficient or improving other factors like safety. They’ve got the job anyway.
I would also argue that the individuals responsible for making public infrastructure decisions know they will be long, long gone when ‘safety’ issues would become apparent…say in 10 or 20 years. It could be the farthest thing from their mind, and it wouldn’t matter.
Public officials are also susceptible to a host of other incentives other than winning business and making a profit. Special interest pressure. Bribes. Hints of a promotion if they tilt the contract this way, or that way, towards a favored campaign contributor. Nepotism.
A transparent, competitive bidding process can go a long way towards fleshing these issues out and competing them away.
How do I fire a federal transportation official, if they do a bad job? For that matter, how does my US Representative? They can’t. They have very limited power to do anything, once a federal bureaucracy is established.
Federal employees are about as far removed from accountability to their customers (you) as one can imagine.
Maybe they are concerned about safety. Maybe they aren’t. Maybe they will run an efficient, tight organization. More likely, they won’t.
But you have no control over them. And in absence of a competitive process, there is zero accountability for them to get better.
In case you had forgotten, here is a clip from the Minnesota bridge collapse:
http://www.nytimes.com/2008/01/15/washington/15bridge.html
And on a similar vein, here is a thread from 1996 whereby the FAA is soliciting contracts to replace vacuum-tube technology in its air traffic control radars. Does that sound safe to you?
No, I hadn’t forgotten about the Minnesota bridge, and nothing else you said was news to me. I still don’t want some private entity out to make a short-term profit in the game of maintaining our traffic arteries. I also don’t want some unknown private entity to have the power to disrupt major travel routes.
Like I said, maybe I’m misunderstanding the scope of your argument, but it seems like a horrifically bad idea to me. In any case, I’d be happy to discuss it if you want to start a thread on the topic, but I don’t want to hijack this one. Are you at all interested in responding to the commentary on nationalized health care?
Only that its similar.
I think citizens are deluding themselves if they transfer decision-making authority for what can, and can’t be done, and what will, and won’t be done, to unaccountable public officials.
Deluding themselves by thinking that somehow, that outcome will be better because those public officials aren’t concerned about ‘profit’. Maybe they aren’t, but they are incentivized and susceptible to a whole host of other pressures that have nothing to do with satisfying you…the customer. And they are completely unaccountable if they screw up.
Putting the most power possible in the hands of you, the consumer, is the answer. Not transferring it to the government. That’s why I prefer health care reform that deregulates and removes barriers to competition, and simply places resources in the hands of the poor (via straight cash, or vouchers) and lets them make choices accordingly. They can fire a poor performing company if they want. They can’t fire an incompetent or inefficient government official.
It is not a delusion.
The reality is that the CEOs of private insurance companies are unaccountable.
So, this is after customers complained, after being grilled in congress and publicly shamed; and yet, they still said that nothing will change.
UHC or as a compromise, a public option, is the right thing to do.
The barriers to competition are imposed by the health companies themselves. Why do they want to compete? They can price control and divvy up the markets. They continually merge and buy up other health companies. That is to eliminate competing. If we have a public option ,they would have to compete. How hard are they fighting against that. Corporations are not our friends. They need to be controlled like a mad dog.
They are completely accountable if the consumer can drop them and go with another carrier. Which is extremely difficult in most states, due to the suffocating thicket of regulation that creates extremely high barriers to entry for new competitors and often results in only 2 high-cost providers.
On a somewhat related note, a Times article about the pork, earmarks and other special favors being larded into the bill purported to be the ‘right thing to do.’
What was that I said above, about public officials being incented by something other than ‘profit’ or ‘safety’ or ‘effectiveness’? In this case, it’s obviously campaign contributions.
http://www.nytimes.com/2009/09/22/health/policy/22earmarks.html?_r=1
So yes, they are accountable but then they are not. 
While I do see that as a little bit reprehensible, the reality is that I see no way for the final bill to avoid all influences from contributions. It is more reprehensible IMO that the politicians (including some democrats) who want the health care reform bill to fail are in the pockets of the insurance industry.
http://www.theseminal.com/2009/06/18/insurance-industry-abuses-the-list/
Let’s go the other way. If privitization is so good for health care, then why not everything else? Why not implement total capitalism?
Police: Just this morning someone broke into the cars in the driveways of about 5 people on my street. I had foolishly left my wallet in my car. The socialized police force took all of our information, and later dusted my car for prints. If we had all had private security firms (which I’m not sure how could possibly cost less than what I pay in taxes for this service), then we’d all have to hope that our various security companies colaborated with their individual findings. (About 8 hours after this incident that the city police were handling, a member of the county sheriff’s department knocked on my door to tell me that they had found my credit card. I informed him of the situation and directed him to the city police. Depending on how well the city police and county police cooperate, perhaps this is an argument for a less locally organized police force. Perhaps a state police force would work better than local ones? [I’ll wait to see how well they cooperate before going that far.])
Education (this is probably most analgous to healthcare): IMHO, if it were not for public education, then the country would be the same as the south was 150 years ago. The wealthy ~10% (the aristocracy) would have private tutors come to their mansions before sending their children to private schools; while those having the misfortune of being born to a laborer would remain illiterate, and therefore almost certainly doomed to remain in the same lower caste that their parents were. This would not be good for the country as a whole. [Google Harold Mann]
FDA: While I believe in the invisible hand, I think that salmonella moves faster. I’m guessing that the tax on chicken that I currently pay is less than what I would spend on toilet paper.
Military: [I don’t think I need to elaborate]
It’s late and I’m tired.
But…
Problem solved: If your insurance company isn’t doing right by you, just replace them with another.
[last one before I go to bed, I promise.]
The problem with the food analogy is that, while one could feasibly live off a couple dollars a day in food, there’s nothing that I can think of that would suddenly make your food costs jump to > $1000 per day.
Again, I think that public education is much mor analogous to healthcare than food. I’m sure that back in the day there were people who said “Why in the hell should I have to spend my hard-earned dollars to pay for the kid of some lazy mill worker to go to school? I’ve hired a private tutor to teach my kid Latin and Greek… why can’t those lazy bastards?” Fortunately for the country as a whole, that minority didn’t win out.
American’s seriously pay over $100 for a simple GP visit?
Normally I pay around $30 (SGD) including medicine.
My father inlaw pays around $120 every three months for his blood pressure medicine.
My tax bill last year was $200
I can visit a specialist whenever I like.
When I hear that insurance follows your employment I think you must all be serioulsy barking and mouth frothing insane. Why the hell would I want to be tied to an employer like that?
Whether you want UHC or not, whether yoy think it reduces freedom or not, something quite obviously needs to be done about the current system.
Oh yah - and to suggest that having UHC makes you less free is also insane. OK - I grant you that having to interview for a GP sucks, but that’s not the default in UHC, just check out Australia, Taiwan, England or New Zealand for case studies. Less freedom comes from other regulatory means, not from UHC per se
That’s what is happening – the insurance companies are performing so poorly that the general public is firing them and moving forward with socialized health care.
You have it backwards. Only shareholders vote in corporations, wheras the entire electorate in a jurisdiction gets to vote in a public election.
I pay around $2. Medicine can cost another $10 at the most.
Our insurance is picked by the company you work for. You do not have the ability to change them when they give bad service or deny coverage. There is no competition. If competition started somewhere, a merger would occur with papers claiming how the merger is good for the consumer. it is not.
The company would like to give you good insurance but they can not. Coverage goes up relentlessly in cost with less coverage on a continuing basis. It is not a buyers market. Your company is notified of changes and cuts every year. It sucks,.
Here’s a charming example of just how effed up this system is. NajaHusband is a post doc at a state university. He works for a lab but technically is employed by the state, so his insurance plan is really pretty good, comparatively speaking.
Early on Friday I had a very mild case of the sniffles. Drippy nose, a little fatigued, a little sneezy, no big deal, could have been seasonal allergies. Starting around 6:30 I started coughing. By then my doctor’s office had been closed for an hour and a half. By 9:30 I was beginning to hack up wads of rubbery green stuff and breathing with what felt like about 30% of normal lung capacity. NajaHusband asked if I wanted to go to the hospital two blocks away for a prescription cough suppressant/expectorant and an inhaler. I pulled out the 1/2" thick packet which details our insurance coverage and start flipping through to find out what it might cost.
This takes a half hour or so (cough cough, wheeze wheeze) by which time I determine that for hospital visits we pay 20% of the tab per visit, meaning that if they want to do a chest x-ray, breathing treatment, etc, we could be looking at hundreds or thousands of dollars. The upshot is we have a $2000 “in-network” cap, so at least we know we won’t be paying more than two grand for my cough syrup. There is an urgent care facility in the next town over, but it’s “out of network”, meaning our bill is 30% with a cap of $6k :smack:
There were no other options to choose from, in terms of insurance plans. Six years ago when he first signed up, the fee for an ER/outpatient hospital visit was a flat $50. We get a new 1/2" thick packet every year.
My doctor isn’t in again until Tuesday, so pretty much I’m Effed in the A unless it becomes such a crisis that we’re willing to empty our checking account and a chunk of our emergency savings to treat a truly “emergency” situation.
Let freedom ring, baby :rolleyes:
I hope you start feeling better soon NajaNivea, and that you don’t have to get medical care.
Some freedoms should be taken away by the government. The freedom to sell adulterated food. The freedom to commit consumer fraud. The freedom to abuse employees. All of these freedoms should be restricted by the government. I support restricting freedom. Don’t you?