It’s not about being much more efficient. It’s about not having to break even.
Even a perfectly efficient private company would have trouble against a competitor that’s cheerfully operating at a loss for decade after decade after decade.
True, but to the best of my understanding (realizing of course, there are a lot of ideas out there and things may change), the idea behind the public option is that it won’t be able to do this. It will get an initial amount of money from the government, and then will be expected to be self sustaining without any further government subsidy.
Once again, that has not been the case in other countries, has it?
I think his point remains valid. His point was that the private insurance companies weren’t in direct competition with the UHC.
No, it’s reasonable. Private enterprise will still provide most Americans’ health insurance; private insurers won’t have the ancillary role in the US they do here. Why would they suffer? They may not clean up the way they do now, but they won’t go bankrupt.
And what if they do? I don’t lament the collapse of the buggywhip industry, why should I care if Aetna’s business model isn’t up to living in the now? If they can manage, great! If not, so what?
I’m always confused by the dual nature of arguments against UHC in the United States. We have people saying:
- The government would offer health care cheaper than the big companies could match, and gradually drive them out of business.
and
- The government is totally inefficient and could not run anything properly, so why trust them with your health?
How can the opponents of UHC hold these thoughts in their heads simultaneously without suffering cerebral ischemia?
** The Other Waldo Pepper ** had a stab at this, by supposing that government health has an unfair advantage by being able to operate at a loss; however the government is already putting tons of money into healthcare - and so what if they have an unfair advantage if the net result is better care for more people for less money, resulting in an improvement to society as a whole. That’s what government services are mostly about, right?
It’s stunning to me to see so many people argue that the rights the government should hold primary are not those of the people, but of the insurance companies. That the perceived proper goal of government, for so many in the health care debates, is not to “promote the general Welfare” but to preserve the bonus-paying capabilities of major campaign donors. That those asserting those arguments want policies that will hurt them and not help them, and perhaps even know it.
The government has no plans on operating at a loss. The natural efficiency of a government system will allow them to provide better health care cheaper. You will pay less in taxes than you do for insurance and will get better care. They have no mandate to maximize profits. That mandate forces insurance companies to cheat their customers. Otherwise you would not be maxing profits. Health care should not be a for profit enterprise.
What about both? There’s another thread going on right now where folks are debating whether the government should fine individuals for not buying health insurance; can’t someone argue in favor of free markets, for both the people and the corporations against the government?
If I think the authorities should get a warrant to tap a man’s phone, isn’t it okay for me to think they should get a warrant to do likewise for a corporation? If I’m against them taking your property without just compensation, can’t I also oppose them doing the same thing to IBM or Coca-Cola?
It seems like there is a lot of double talk in this thread. Some are glad to be rid of private insurers. Fine, that’s an honest position but not one that has been forwarded by the President.
He has also talked of “keeping the insurance you have” and in my mind that means a private policy in the same market that they are in now. So this argument:
is meaningless because it is not referring to the same “private insurance” that we have in the U.S.
That may be good, bad, terrible, screw 'em, whatever. There are several other threads. My only question is that this particular argument cannot be made because there is NO other country in the world that has a system like the one that Obama is proposing. Fair enough?
Those two positions are not “dual”, they are identical. The government is able to provide a product that is cheap to the end user while the program is terribly inefficient.
In other words, the health care is only cheaper in the sense that the direct payment from the end user is less. The overall cost is enormous. Medicaid is virtually free to the user but very expensive to the taxpayer.
What part of “they can adapt” eludes you?
Yes, we’re all unique in our own special ways, aren’t we? But we can learn from each other. It would be foolish not to try. The rest of the world is just as real a place as the US, and the people there are just as real too. I know, I’ve been to some of it.
The system Obama is proposing actually gives the insurance industry more power and more leeway than the successful systems implemented in virtually all of the rest of the civilized world. It will be less cost-efficient and do less to “promote the general Welfare” than most of theirs. So why does the whining continue?
The two points are not incongruous.
Let’s assume that “basic” insurance coverage has a market clearing cost of $100/month premiums. The government can mandate that their costs are $50/month. In order for the private insurer to do that, he will have to cut benefits, labor and otherwise improve operational efficiency. Those that cannot compete at the government’s price point are either driven out of the industry or change their offering where the government does not compete, like in the area of providing gap coverage. The government does not have to return a profit, and can remain unprofitable far longer than any multi-billion dollar company.
Likewise, the government does not need to provide any organizational efficiency. The government’s very structure removes any sort of price information or feedback. People cannot vote with their feet (which has a much more immediate effect than actual voting every term) and choose another service or government. In the case of health care, citizens MUST use the government service, and have to leave the country if they wish to pay for better/quicker/alternative/whathaveyou treatment. Particularly, this is where possibly long wait lines and bureaucracy come into play, or some other form of rationing of care.
The point is that the public option, run at a loss, is going to take more money to bail out. For example, look at the medicare cost projections, and look at what happened to the previous projections – they were off by a factor of 10. How will the spending stop? Until we know more specifics, this is one major issue that any UHC or public option plan must address.
Right, but the idea is that the public option won’t be run at a loss. The plan is for it to break even.
Sure they can adapt, but that is not what is being sold to the public. “You can keep your current plan” is what has been pushed.
Am I to assume that you are saying that this is a three card monty game pushed on the unsuspecting public? Make us think that when you say “private insurance” you want us to think you mean the private insurance we currently have, but really mean “private insurance” as in the vastly reduced supplemental companies that will exist in the future?
Your whole second paragraph about “learning” from other countries is great, but that is not what I am asking. And if we “learn” from other countries then we certainly aren’t able to “keep our current plan if we choose”.
And if there is a shortfall, and the program doesn’t look like it will survive, will it:
- Raise premiums
- Raise taxes
- Cut benefits
- Borrow money from the treasury to sustain the program.
And here’s a hint: When a crunch comes, private insurers can’t do #2 or #4. Who has the advantage?
They can sure as hell do 1 and 3, along with just dropping people’s coverage entirely (#5). The government couldn’t do that, would have great trouble doing 3, and would face hell trying 1.
So yes, who has the advantage?
As in, it won’t be the government taking it away from you. Your current insurer, if you’re lucky enough to have one, can take yours away right now. Your employer can, too. The government won’t, though. See?
You’re strenuously dismissing all of their experience, as if it weren’t relevant or illustrative. Why is that? Merely because of its inconvenience to your position, or because of something respectable you haven’t explained yet?
Guess what? You can get private insurance in almost any of those countries anyway. Those companies have found a way to exist and thrive somehow. Amazing, ain’t it?
The government. #4. They can do that until society collapses. The private insurers could only borrow money as long as the banks would keep lending or shareholders keep investing. Government program wins. Welcome to National Health Care.
Now, I know that you think that is a good thing. My point is that what we are being sold is nothing like what is a natural consequence to it happening.
I think that you are being deliberately obtuse. Let me say it again:
Definition #1. Private Insurance (U.S. Version)–primary method to pay for all forms of health care
Definition #2. Private Insurance (rest of world)–supplemental secondary insurance to pay for minor things not covered by government UHC plan.
You use definition #1 and switch to #2 and back and forth again.
I understand that private U.S. companies could switch from 1 to 2. What I am saying is that this plan is being sold as “keep your private insurance if you like” knowning that people are thinking of #1 while you are hitting them with #2 from the back end.