I want the government to run my health care
I hear all the time from Republican politicians that a government-run healthcare system is a bad idea simply because it is government run. The smug rhetorical question is "Do you want the same people that run the Post Office and the DMV running your healthcare?"
I don't understand why there isn't more pushback on that. I do a lot of mailing for my business and I have no problem with how the Post Office operates. As for the DMV, they are slightly more of hassle, but not very frequent. DMV is a state deal anyway.
My parent's and my wife's parents are on Medicare and they are perfectly happy with it. On the other hand, my health insurance company has been far more hassle than the Post Office and the DMV combined. My push back on the Republicans is "Why would someone prefer a private health insurer over a government run healthcare program? Why would someone want to trust decisions concerning life, death and health to an outfit with a profit motive?"
Swish. Two points!
July 19, 2009 12:12 PM | Reply | Permalink
Nothing but net!
July 19, 2009 3:21 PM | Reply | Permalink
Folks, these knuckle draggers are hoping to use scare tactics in the recess to 'kill' Healthcare..THe congress is writing this bill NOT THE PRESIDENT! The repubs have brought no input of consequence to the table and are whinning about 'bipartisen'---
Healthcare is not a partisen issue it is a American voter issue!
Our airways in Colorado are flooded with scare tactic lying ads against a bill they say is the PRESIDENTS...IT IS NOT WRITTEN BY THE PRESIDENT. BUT CONGRESS
CALL THE FOOLS AND TELL THEM TO GET TO WORK! 1.800.828.0498
July 20, 2009 9:37 AM | Reply | Permalink
Governments are run by politicians, not businessmen. Politicians are first and foremost concerned about getting re-elected, economic decisions come second. They will have a short-term bias rather than a longer term view. They will also favor parochial interests over economic sense.
Capitalism isn't perfect. But only the profit motive and competition can force entities to stay lean, efficient, innovative and customer-oriented.
July 19, 2009 12:42 PM | Reply | Permalink
Make-believe assertion.
July 19, 2009 1:14 PM | Reply | Permalink
only Really?
lean, efficient Aren't those descriptions of ways to improve profits? Maybe healthcare could slow down and "see" the patient rather then have a doctor dancing through the rooms like a rat in a maze chasing a piece of cheese. Lean and efficient are profit-motivated goals. Let's get the least to do the most, or at lest appear to do the most.
innovative, not like NASA, though.
customer-oriented Jeezus! That's just laughable. You didn't type that with a straight face, did you? It's so hard to tell on the web what the author was doing as they typed. I know I couldn't do it. I'm still laughing.
July 19, 2009 3:27 PM | Reply | Permalink
You want politicians to run it that are more concerned about getting elected?
July 19, 2009 8:14 PM | Reply | Permalink
What a seriously ridiculous question.
Do you think that Mitch McConnell is going to be sitting in his senate office deciding whether or not you get radiation treatments for your cancer?
How is some bureaucrat running healthcare any worse than someone who has a financial incentive for denying me coverage?
I grew up under "government-run healthcare". European, you think? Nope. US Army dependent. I was born in Coco Solo Hospital in the Canal Zone while my father was stationed there and from that day forward until I got through college every immunization, stitch, strep throat, dog bite, etc. was taken care of at a military hospital.
I had my appendix removed at 4, my brother was in a life-threatening accident at 17, my father had two seperate operations for hernias, and my mother had to be treated for severe stomach ulcers on several occassions. There was never any hand-wringing over insurance coverage, pre-existing conditions or prescription costs. I think (although I'm sure it's all changed now) all that needed to be paid for was the cost of meals if you were hospitalized. There weren't any outrageous wait times for appointments or services and I believe the biggest pain was that getting a prescription filled at the pharmacy took forever (at least in the eyes of a child who had to sit and wait for her number to be called).
Both of my parents as veterans still receive their care through the local VA center. My dad occassionally will see a civilian doctor but prefers the VA. Less hassle he insists.
I understand that not everyone's experience is positive, but you know what? There are horror stories on both sides of the issue. I, personally, just get fucking sick and tired of people (and particularly those who have never experienced it)pissing and moaning about "governemnt run care". After spending last week arguing with our insurance company about coverage for my twin sons, I personally miss those nasty, terrible "bureaucrats".
July 19, 2009 9:25 PM | Reply | Permalink
It's the politicians - McConnell and others - that will be deciding how the program works. They will make decisions primarily to maximize their chance of getting re-elected and not necessarily what makes economic sense.
How is it any worse? Well for starters it's going to cost us at least an extra $1 trillion over the next 10 years. Take a look at Medicaid - is that what you want? Ask someone first who is on it before just saying yes
July 19, 2009 11:00 PM | Reply | Permalink
Empty argument. Is there something specific about medicaid that you would like me to look at? And BTW, I'm very familiar with medicaid. I saw it time and time again in my last job: people who were diagnosed with late stage cancers in the emergency room because they didn't have the resources to visit a doctor earlier. Who do you think then paid for their care? Many of these people could have survived if they had access to earlier medical care. This is why I alway chuckle when I hear reps say that "socialized" medicine is going to kill people. Our current system is doing a pretty good job at that already.
Why do you hate democracy? Isn't someone making decisions on what or what might not get them re-elected the basis of our political system? Isn't that why the founding fathers made the legislative branch the first article in the constitution? And again, I ask you: why is someone making decisions based on "political" considerations any better than someone making decisions on "economic" considerations when those considerations are designed only to benefit a few? Do you think it's going to make me feel any better if I get dropped from my insurance because it was based on an "economic" consideration?
People keep throwing numbers around, but what will not acting cost us? Do you really think we can continue on this current path? If not, then let's hear some solutions...because other than HSA, I haven't heard crap from the other side.
July 20, 2009 8:29 AM | Reply | Permalink
If you don't appreciate how making decisions based on economic decisions isn't better than making decisions that ensure you get elected again, it's probably not worth having the discussion.
A doctor I know says that Medicaid reimbursement rates are so low and billing is so complicated that it leads to worse care. Only half of doctors take new Medicaid patients compared to 70% that accept new Medicare ones. Not to mention the fraud and abuse that has taken place...
July 20, 2009 1:46 PM | Reply | Permalink
The problem is that the current "economic-based" decisions in healthcare are not there to benefit society as a whole - they are there to solely benefit the bottom of line of the insurance company. I guess if my insurance company drops me, even though I have regularly paid my premiums and played by the rules, according to you I at least can stand up, salute the flag, and thank God for capitalism!!!
I agree with your issues with Medicaid now that you finally opted to vocalize them. Funny, though....isn't medicare solely administered by the federal government while medicaid is administered jointly with the states? I thought the end-all-be-all of conservatives was "states do things better than the federal government". Maybe not so much, eh?
Fraud and abuse takes place all the time in private insurance programs also....what's your point?
July 20, 2009 3:09 PM | Reply | Permalink
My point is that there will be less waste if it's run in the private sector than if it's run by the government. Remember all the wheelchairs and hospital beds that Medicare wasn't accounting for properly? Last year the GAO said that one-third of all medicare disbursements for durable equipment were improper or fraudulent. I'd like to see stats you have on the private sector that shows the fraud/abuse is as large as that.
In the private sector companies know that in order to maximize their profits they need to provide customers with the best services and products. But in the public sector politicians are running businesses with other people's money (ours!) and have one priority - getting re-elected. And their voters may have different needs than the country as a whole.
If your insurance company drops you, there will be other insurance companies out there in a competitive marketplace that are looking to serve your needs.
July 20, 2009 3:51 PM | Reply | Permalink
Awesome. Then I suppose you're agreeable to privatizing the Department of Defense?
I never argued that the fraud was "more". I was just pointing out that there is fraud in every sector of society. There are people who take advantage of the welfare system, the SS system, etc., etc. The question becomes does the benefits outweigh the costs? I think people who defraud the system are leeches and low-lifes and should be locked away.....but do I think that some disabled person who can't afford a wheelchair suffer for someone else's crime? No.
Except that's not the case for most pepole. I'm super pissed off at my insurance company right now because I got three different answers from three different individuals last week over our coverage and I still can't get a straight answer from anyone. I can't threaten to take my business elsewhere - I am currently "stuck" since this is the insurance my husband's company has contracted with. My only hope is that a complaint to HR might carry some weight when deciding whether or not to renew. What do you think my husband's employer is more worried about? A bitching employee or the cost of switching?
I guess you've never heard of a "pre-existing condition?"
July 20, 2009 4:27 PM | Reply | Permalink
The Dept of Defense already outsources a lot of its needs. Have you ever heard of General Dynamics or Alliant Techsystems?
We can force insurance companies to take people with pre-existing conditions. We don't need to have a public option to accomplish that.
I brought up fraud and abuse and you effectively said that that type of stuff occurs everywhere so it's a wash. Not really. Medicaid fraud is rampant and needs to be fixed. I believe it exists because those running that system are playing with other people's money and don't care if the system is full of excess. I doubt those government employees get bigger bonuses based on the efficiency and profits of the system.
July 20, 2009 4:44 PM | Reply | Permalink
That's worked out really well, hasn't it? That's cut back on all of that fraud and abuse, right?
http://www.wtvynews4.com/military/headlines/45722437.html
And this is my personal favorite:
http://abcnews.go.com/US/story?id=4489783
So much for your thesis that "private sector companies know that in order to maximize their profits they need to provide customers with the best services and products."
I said that I agreed with you about medicaid fraud. I never said anything about "a wash". Nice strawman. What I said was that I don't believe that the innocent and those in need should pay for someone else's sins.
Let's face it...you and I just have a different view of the role government can play. As I said earlier, I've had nothing but positive experiences with commie-style medicine. You can continue to rant about medicaid in post after post, but I have yet to hear you answer a question I posed at the beginning: Do you think we can continue on this current path? If not, then what's your solution?
July 20, 2009 5:23 PM | Reply | Permalink
No we cannot continue on the current path. We need to get the employer out of the mix and put the individuals (ie the customers) face to face with the insurance companies. Let people choose from all providers, not just the ones that their employer has deals with. We also need to take a different approach to our obesity problem. European countries have better life expectancy not because their model is "better" but because one-third of their elementary school students are not obese. We also need to do something about the runaway malpractice costs that are terrorizing our legal system and driving good doctors out of business.
There are so many things that can be fixed without creating a "public option"
Do we pay too much for healthcare? Probably yes. But if you are the person who needs treatment, maybe the answer is "not really". If you can't get the medical help you need when you need it, maybe the fact that it is theoretically free doesn't mean anything.
I just hope that when I get diagnosed with a terminally ill disease that I will have the option to try some radical treatment.
July 20, 2009 9:14 PM | Reply | Permalink
Do you think that politicians run the FAA? The Post Office? The DMV? Get real!
If you want an example of what the politicians run, you can just check out the CIA.
July 20, 2009 10:36 AM | Reply | Permalink
The politicians were certainly involved in shaping how those agencies operate. They don't "run" them on a day-to-day basis but they certainly drive the major policy decisions. And they will make those decisions based on short-term election reasons and not long-term economic factors
July 20, 2009 1:28 PM | Reply | Permalink
Paul - Your point is well taken. There is an even more convincing example relevant to healthcare.
Of all the industrialized nations, the U.S. stands at the bottom in the sense that the others surpass us by covering more citizens at much lower cost, and with better health outcomes as measured by standard WHO criteria. These other nations all have some type of strong public component - single payer or otherwise - while our health care delivery is exclusively private outside of selected populations (e.g., Medicare recipients).
In contrast to our bottom position in providing health care, we stand far above the rest of the world in our ability to perform the basic biomedical research that leads to spectacular advances in disease prevention and treatment. Our lead comes principally from the NIH (National Institutes of Health), which is a federally managed organization run by bureaucrats (with the advice of expert scientists), and funded by income tax dollars.
The disparity is striking - private health care delivery is the worst and most expensive among all the nations, whereas government run medical research is one of the most successful enterprises in the history of the human species.
I don't claim that government run programs are always far superior to private operations, but the notion that they are always inferior is so absurd that anyone who promotes it should be embarrassed.
July 19, 2009 1:37 PM | Reply | Permalink
It's probably unfortunate that healthcare reform has been diluted into so many separate postings, because much of it has already been covered.
Based on comparison with other systems, and with reasonable estimates, we can expect a reform package that includes a public option to reduce health care costs by hundreds of billions of dollars, if not trillions, over the coming decade, in comparison with the costs of continuing an unreformed system. Where MiddleClassBill and others get confused is in the attribution of costs and savings. The reform package would indeed cost the federal treasury a substantial sum - e.g., a trillion or more. However, this would be greatly outweighed by the savings to consumers, and so the net effect is significant cost reduction for the nation as a whole.
July 20, 2009 12:50 AM | Reply | Permalink
If you want the government to manage your health care, you should have it that way. But if you're proposing to force other people who don't want government-run health care to use it OR PAY FOR IT whether they like it or not, you're no better than the Republicans who think they have the right to tell you who you can or can't marry. This country is supposed to be about freedom, not having a contest to see who can force other people to live the way they want everyone to live.
As an aside, have you ever considered what will happen to a government-run health care system the next time the Republicans are controlling the government? Our doctors will be prescribing Billy Graham videos!
July 20, 2009 2:33 AM | Reply | Permalink
But of course the private plans are free to cherry pick the young and healthy leaving the public system to bear the high cost clientel.
So here is what I propose (like anybody will think this could happen): Private insurance is fine but they must accept all comers, charge all clients the same price and insure all clients with the same coverage.
Put the private versus public option on that head to head basis (as in fair competition) and private health insurance as we know it, will whither away in a decade.
July 20, 2009 6:31 AM | Reply | Permalink
Under the proposed legislation, the private plans will be compelled to accept applicants rather than cherry pick, and will not be permitted to reject individuals for pre-existing conditions.
July 20, 2009 10:36 AM | Reply | Permalink
It seems that just about everyone in this discussion, like Obama, thinks that "the private option" is a continuation of employer-based health care. Getting health insurance from your employer never made sense, and the only reason it persists today is that idiot politicians - the same politicians who would manage a government-run health care system - have tilted the tax code in its favor.
Does your employer really know what kind of health insurance you need? Do you need the same kind of health insurance as all of your co-workers? Of course not!
The real problem with the current system is that as long as most of us depend on our employers for our health insurance, we have less freedom to penalize health insurance companies for bad service (including the denial of claims) and high prices. A monopolistic government-run system would leave us with the same inability to penalize bad service or high costs. Taking profit out of a monopoly doesn't make it work well.
July 20, 2009 5:03 PM | Reply | Permalink
My purpose in writing this post was to push back on the meme that just because government runs something, it’s bad. There are some things private industry does just fine, but there are a lot things that are better off left to government. Some examples: the U.S. Military vs. Blackwater; NASA vs. ?; FDA and local regulation vs. self regulation by the food industry; U.S. Government regulation vs. self regulation by the financial industry; US EPA vs. environmental self regulation by industry. There are many others.
The health insurance industry now does all the same things that Republicans warn us that a government run system will do. Ration healthcare? Sure, my health insurance company does a lot of that. Get between me and my doctor? My health insurance company does that too. Health care run by bureaucrats? Got me there, although many of the people I’ve spoken to at my health insurance company would make very fine bureaucrats. My point is that the main difference between a government run system and my insurance company is that government decisions about my health care are not automatically driven by profit motive. To me, that makes a lot of difference.
July 20, 2009 8:13 AM | Reply | Permalink
I understand that your post wasn't about the compulsory nature of the typical government-run health care proposal. I brought it up because I think that's the main problem with government-provided services - they usually have no competition, which means there is no incentive to improve the quality of the services or provide them at lower prices.
The USPS is a great example. You say you have no problem with the USPS, and that's fine. But no one knows whether first-class mail could be delivered more quickly, at a lower price, etc., because the US has a law that grants a monopoly in the first-class mail business to the USPS. It's against the law for you to start a first-class mail delivery business without consent from Congress, and Congress has delegated to the USPS the power to decide whether that consent is granted. In other words, the USPS has the authority to decide whether you can compete with it.
That's not what I would consider to be a good model for health care.
So if you want government-run health care and you want to keep using the USPS, that's your decision. But those who want the government to provide these services have no business forcing others to conform to their opinions.
July 20, 2009 3:53 PM | Reply | Permalink
I guess we are getting into the philosophical weeds on this one. I would argue that, lack of competition notwithstanding, government is better off running some things including the post office and health care. I think when things are of important enough interest to the country as a whole, having the government run them is appropriate and essential.
Also, lack of competition does not automatically lead to government services being of low quality. For example, I think the military does just fine without having to compete against mercenaries. When mercenaries have gotten their chance, as they did under Bush in Iraq, they failed miserably.
Also, when quality of services in government does suffer, as did with FEMA and Katrina, there are consequences. These consequences are born by bureaucrats, who get fired, and politicians, who lose elections.
Finally, if private industry is doing such a great job with health care, then why are people clamoring for change? Why did both presidential candidates during the 2008 election call for change? The health care industry hasn’t mended their ways because competition has called them to task for their poor service. They have no competition. They do whatever they want. They operate with a corrupt business model that keeps people sick and sometimes kills them while raking in huge profits and driving up costs for everybody. If I had my druthers, the government would set up a single payer system and run the whole thing, like they do everywhere else in the industrialized world. It would certainly cost less, there would be better health outcomes and even if it’s not all that great, I’m pretty sure they’ll do better than private industry does now.
July 20, 2009 5:43 PM | Reply | Permalink
One of my other comments to your blog will answer the questions you just asked about the failings of the current health care system:
It seems that just about everyone in this discussion, like Obama, thinks that "the private option" is a continuation of employer-based health care. Getting health insurance from your employer never made sense, and the only reason it persists today is that idiot politicians - the same politicians who would manage a government-run health care system - have tilted the tax code in its favor.
Does your employer really know what kind of health insurance you need? Do you need the same kind of health insurance as all of your co-workers? Of course not!
The real problem with the current system is that as long as most of us depend on our employers for our health insurance, we have less freedom to penalize health insurance companies for bad service (including the denial of claims) and high prices. A monopolistic government-run system would leave us with the same inability to penalize bad service or high costs. Taking profit out of a monopoly doesn't make it work well.
July 20, 2009 6:08 PM | Reply | Permalink
Paul,
Great post. It's just what I've been thinking and you said it so economicaly.
July 20, 2009 6:35 AM | Reply | Permalink
Fred's got a point about 'divided we fail'. But I really want as many points as possible covered in as many blogs as possible.
Keep the issue alive and humming.
Thank you for your post.
July 20, 2009 7:51 AM | Reply | Permalink
You're right. It's just that it's frustrating to knock down a spurious argument in one post and then see it repeated in another. Still, I agree we should be willing to do it.
July 20, 2009 10:39 AM | Reply | Permalink