Postal Service an Indicator of potential Healthcare System?

[blazerboy30]

Does GM show how bad the private sector is at making good, efficient business decisions?

barfo

It shows had a single company in the private sector was bad at making good, efficient business decisions.

Care to show some examples of really well run, efficient government programs?

 

[blazerboy30]

Not really true. My wife's business ships thousands of packages a year. Nearly everything is by USPS because it's just cheaper and more convenient. We've looked at UPS and FedEx, and for our particular parcels it just makes more sense to go USPS.

Yet USPS is experiencing huge deficits. Clearly there is a reason they are able to deliver certain types of packages for cheaper... they aren't held to the same profitability requirements as a private company.

BTW, when I have had packages to send, I found the opposite as you for cost and convenience.

As for profitability, UPS, FedEx and the USPS have all had really bad years. The economy sucks. If people buy less stuff, they need less stuff shipped. Add in increases in bandwidth on the internet, and it's pretty easy to see why they all are struggling.

Sure, the economy is going to have ups and downs. These cycles are a huge part of what makes the public sector so inefficient. They don't or can't scale back when they need to. Private companies scale back in bad times. Some public programs pay people to sit in a room, doing nothing.

Anyway, I do see some similarities between this and health care. The USPS in the analogy is the public option. FedEx and USPS are the private insurers. Each seems to fill a particular niche, but each has drawbacks. It's hard to imagine a private company building the infrastructure needed to replace what the USPS does, and it's hard to see how private industry would want to insure, say, a 50 year old man with terminal cancer.

I am fine with the argument that there are people who don't have coverage, and need coverage. But, these healthcare proposals should not be campaigned with the idea that overall healthcare spending will go down, or that a public healthcare system will somehow be cheaper and more efficient (with the same level of care) than the private sector.

 

[mobes23]

What squirrelly point is this thread trying to make? That private for-profit companies are more efficient in generating profits than government programs that by definition focus on serving the general population (in other words, things other than profits)? It's like trying to compare apples to oranges and being excited because you've discovered apples and oranges are different.

Nice work, Sherlock.

 

[Denny Crane]

What squirrelly point is this thread trying to make? That private for-profit companies are more efficient in generating profits than government programs that by definition focus on serving the general population (in other words, things other than profits)? It's like trying to compare apples to oranges and being excited because you've discovered apples and oranges are different.

Nice work, Sherlock.

A major claim of those who favor nationalized health care is that the government can do it more efficiently than the private sector.

It's fair to ask about any precedents in government programs where they do actually do something more efficiently than the private sector.

 

[mobes23]

A major claim of those who favor nationalized health care is that the government can do it more efficiently than the private sector.

It's fair to ask about any precedents in government programs where they do actually do something more efficiently than the private sector.

How many government programs directly compare to the private sector? Very few, because the private sector will always focus on profit generators and exclude notprofitable ones. Gov't porgrams never really have that luxury.

To reverse the argument, how effective do you think for-profit companies would be at guaranteeing health coverage for those who can pay zero for it, have pre-existing illnesses, etc.

Honestly, I think the best approach in this is probably some combo of private and public programs. Let the private side handle what it's good at, the public side what it's good at and then add some incentives/disincentives to the private side to make it more worth their while to serve a broader base of the population.

I can't imagine a solution that's purely private or purely public being optimal.

 

[Denny Crane]

How many government programs directly compare to the private sector? Very few, because the private sector will always focus on profit generators and exclude notprofitable ones. Gov't porgrams never really have that luxury.

To reverse the argument, how effective do you think for-profit companies would be at guaranteeing health coverage for those who can pay zero for it, have pre-existing illnesses, etc.

Honestly, I think the best approach in this is probably some combo of private and public programs. Let the private side handle what it's good at, the public side what it's good at and then add some incentives/disincentives to the private side to make it more worth their while to serve a broader base of the population.

I can't imagine a solution that's purely private or purely public being optimal.

So what you're saying is that the congress people and Obama and his staff are lying about the govt. being able to do health care more efficiently (at least cost) - enough to cover everyone that isn't covered and presumably without losing any of the quality of health care delivery we have now.

Fair enough.

Like I wrote a few times now, I favor a public option that is not funded by tax money or cutting other programs. Make it semi-profitable like the USPS. A little competition for the profit making companies is a good thing. Once the govt. insurance company is off the ground, then we can address things like subsidizing the cost for some people.

Otherwise it's going to start off as a money drain and that's only going to get worse as it does just about everywhere else.

And I do mean govt. insurance company - selling health, life, malpractice, auto, etc. insurance.

 

[maxiep]

Does GM show how bad the private sector is at making good, efficient business decisions?

barfo

Are you going to ask the same about Microsoft, Google, WalMart or thousands of other consistently profitable companies?

Find one business the government runs that turns a profit or is run more efficiently than the private sector.

 

[maxiep]

Because of the downturn in the economy, fewer packages and letters are being sent. Currently the USPS has a significant excess in employees. Their solution isn't to lay those people off like a private company would, but to "excess" them to another region. That's no way to run a company you want to just break even (the USPS doesn't seek to make a profit, just not to lose money).

I wonder if we have government-run healthcare, how many of our new government employees will be "excessed" instead of laid off in senior living once the baby boomers die off and demand for those services drop off a cliff?

 

[blazerboy30]

What squirrelly point is this thread trying to make? That private for-profit companies are more efficient in generating profits than government programs that by definition focus on serving the general population (in other words, things other than profits)? It's like trying to compare apples to oranges and being excited because you've discovered apples and oranges are different.

Nice work, Sherlock.

As Denny pointed out, you clearly missed the point.

Nice work, Sherlock.

 

[barfo]

Find one business the government runs that turns a profit or is run more efficiently than the private sector.

The IRS is extremely profitable. The mint as well - it practically prints money.

barfo

 

[MARIS61]

I meant this:

http://www.capmag.com/article.asp?ID=3111

US Postal Service: A Government Protected Monopoly

by Edwin Feulner (September 23, 2003)
If I tell you, "The check's in the mail" you probably won't look for it any time soon--if at all. But if I tell you I've sent the check via FedEx, you'll probably plan a trip to the bank.

We know we can count on private services such as FedEx and United Parcel Service to deliver on time. If they didn't, they'd go out of business. And we also know--many of us from bitter experience--that we always can't count on the post office.

That's because the post office is a government-protected monopoly; 19th century laws make it illegal for anyone else to deliver letters. It's also exempt from state and federal taxes and free from most government regulations. That combination is a recipe for disaster.

A recent report from the President's Commission on the United States Postal Service recognized these problems and recommends creating a Postal Regulatory Board to supervise the post office. This would be a welcome step, but we shouldn't stop there. The overall goal is to make the post office more efficient and user-friendly. That's why it's time to break the post office's monopoly and privatize the delivery of mail.

Right now, there's no competition in the letter-delivery business. Almost all letters must be sent through the post office, unless the letter is "extremely urgent." The post office even gets to set the minimum price its private competitors can charge: A letter must cost at least $3 or twice the applicable first-class rate to qualify as urgent.

I send letters daily to residences all over the country. I don't think I've ever had one take longer than 3 days to get there. Out of tens of thousands of letters. I've never had a piece of mail lost.

Since Fedex and UDP charge 3-6 times that $3 to deliver an "urgent letter", in the same time the USPS gets it there2-3 days, it's obvious this right-wing think-tank libertarian is talking out his ass, much like his standard article template requires.

http://www.capmag.com/author.asp?ID=69

 

[yakbladder]

Yet USPS is experiencing huge deficits. Clearly there is a reason they are able to deliver certain types of packages for cheaper... they aren't held to the same profitability requirements as a private company.

Profitability? No. But they can't just bleed money. They need to break even. Again, USPS is not a typical government agency. They can't just spend till their eyes bleed.

You also have to remember that USPS, all of its infrastructure, operations, etc. were geared for many decades towards delivering the standard letter. Then UPS/Fed Ex got big and they shifted some of the resource towards packages and kept the letters as a money base. Then as email crept up more and more, letters fell way off. Unlike UPS and FedEx, the USPS just can't stop delivering letters because they don't feel it's profitable enough. There are two sides of the coin here.

Also, USPS and FedEx (and most big businesses) continually have their eyes on that stock price. The stock price dumps 1/10th of a cent and, regardless of the "efficiency" of their operation, they start laying people off to jack the price back up. You take the stock market and its wild psychotic effect out of the equation with all private insurers and then we'll talk.

Sure, the economy is going to have ups and downs. These cycles are a huge part of what makes the public sector so inefficient. They don't or can't scale back when they need to. Private companies scale back in bad times. Some public programs pay people to sit in a room, doing nothing.

Some private programs pay people to sit in a room doing nothing. I know because I worked at a few of them and watched those people. Some public programs DON'T pay people to sit in a room, doing nothing. So what's your point? You can't make a statement about one program, at one time in its existence and apply it to all of government at all times.

I am fine with the argument that there are people who don't have coverage, and need coverage. But, these healthcare proposals should not be campaigned with the idea that overall healthcare spending will go down, or that a public healthcare system will somehow be cheaper and more efficient (with the same level of care) than the private sector.

But it may be cheaper. And there will still be private supplemental plans no matter which option is chosen so if you're making enough money you can keep your private doctors. Where's the problem?

 

[blazerboy30]

Profitability? No. But they can't just bleed money. They need to break even. Again, USPS is not a typical government agency. They can't just spend till their eyes bleed.

I'm glad you admit that typical government agencies "spend till their eyes bleed".

You also have to remember that USPS, all of its infrastructure, operations, etc. were geared for many decades towards delivering the standard letter. Then UPS/Fed Ex got big and they shifted some of the resource towards packages and kept the letters as a money base. Then as email crept up more and more, letters fell way off. Unlike UPS and FedEx, the USPS just can't stop delivering letters because they don't feel it's profitable enough. There are two sides of the coin here.

You've just realized the problem. Thank you.

Everybody understands why USPS is struggling right now. It is a perfect example of a government program that is too slow to react to changing times, so when it becomes obsolete or out of date, we just keep pumping money into it.

I'd like to see some evidence that this won't happen to healthcare like it does in every other government program.

Some private programs pay people to sit in a room doing nothing. I know because I worked at a few of them and watched those people. Some public programs DON'T pay people to sit in a room, doing nothing. So what's your point? You can't make a statement about one program, at one time in its existence and apply it to all of government at all times.

When a private company pays people to sit in a room doing nothing, who pays for that?

When a public company pays people to sit in a room doing nothing, who pays for that?

That is the point.

 

[MARIS61]

After the last 5 years of childlike leadership of nearly every large business in our company, resulting in a near total collapse of capitalism in America, you want to completely privatize something as important and dangerous as the mail?

I can think of more constructive, more patriotic, and more profitable things to spend your free time campaigning for.

 

[blazerboy30]

After the last 5 years of childlike leadership of nearly every large business in our company, resulting in a near total collapse of capitalism in America, you want to completely privatize something as important and dangerous as the mail?

I can think of more constructive, more patriotic, and more profitable things to spend your free time campaigning for.

Are you talking to anybody in particular, or just wasting time making random strawmen?

 

[yakbladder]

I'm glad you admit that typical government agencies "spend till their eyes bleed".

Some departments do spend till their eyes bleed because they're so afraid of their budget getting cut. They get thousands of people clamoring each year for government to cut spending everywhere. Every one has a gripe about some department. Yet it seems to be a lot of the social services that get targeted first.

Everybody understands why USPS is struggling right now. It is a perfect example of a government program that is too slow to react to changing times, so when it becomes obsolete or out of date, we just keep pumping money into it.

Except that's totally false as well as contradictory to what I was stating. What I said is the USPS was forced into investing into one main area because it's required to - that's what it was setup to do. The USPS is not subsidized. It is also mandated to not make a profit.

http://usgovinfo.about.com/od/consumerawareness/a/uspsabout.htm

A very interesting article from 1998...

http://www.slate.com/id/1095/

You also don't seem to fully understand why the USPS is struggling right now as well. One of the primary reasons the USPS is in deficit mode right now is because of a 2006 law that requires the USPS to pay more than $5billion a year until 2016 to cover future retiree health benefits. No other agency has this requirement.

I'd like to see some evidence that this won't happen to healthcare like it does in every other government program.

That's a bold statement. Can you provide a link to show that this happens in every other government program?

When a private company pays people to sit in a room doing nothing, who pays for that?

When a public company pays people to sit in a room doing nothing, who pays for that?

That is the point.

You do. You do.

The only difference is one is through taxes. The other is through prices / stocks.

 

[BrianFromWA]

One is mandatory for me to pay.

The other (like, say, Wal-Mart), I don't have to pay for if I don't want the product.

 

[mobes23]

So what you're saying is that the congress people and Obama and his staff are lying about the govt. being able to do health care more efficiently (at least cost) - enough to cover everyone that isn't covered and presumably without losing any of the quality of health care delivery we have now.

Fair enough.

Like I wrote a few times now, I favor a public option that is not funded by tax money or cutting other programs. Make it semi-profitable like the USPS. A little competition for the profit making companies is a good thing. Once the govt. insurance company is off the ground, then we can address things like subsidizing the cost for some people.

Otherwise it's going to start off as a money drain and that's only going to get worse as it does just about everywhere else.

And I do mean govt. insurance company - selling health, life, malpractice, auto, etc. insurance.

Is the government taking over all health care in the U.S.? Honestly, work's been killing me, my one year old keeps me busy when I'm home and I'm admittedly out of the loop, but I didn't think this was the plan. So my employer won't have to worry about coverage for me and my family any more? I'd thought that portions would still be private and some would be covered by Uncle Sam.

If that's the case, then I can see your view for sure. Medicine that's completely socialized sounds like a train wreck to me. While the system is far from perfect now, I really doubt the government would be able to improve on it.

As I last understood it, consensus was that it would be a combination of old system (for profit) and new (subsidized by gov't). This thread makes it sound like it's a complete government take over of the healthcare system and, last I heard, that's a bunch of hooey. Like I said, maybe I've missed something over the last month.

Do I really think the government would do a better job providing insurance coverage for people currently covered by private insurance? No. I'd say let the for-profit companies work their capitalist magic.

Do you really think for-profit companies would have the ability (even interest to pursue a line of business) to provide coverage for people who currently can't get insurance because of pre-existing illnesses or can't afford it? This is the space that likely will need to be provided by the gov't or, at the very least, the gov't applying sufficiently powerful incentives and disincentives to for-profits to make it worth their while.

Maybe I'm wrong, but this thread seems like it's oversimplistic and designed to do nothing more than get people fired up in nonconstructive ways. Getting people fired up is cheap, easy and a waste of time. What we need is fair and honest communication that works toward solutions.

And anyway, how many gov't programs directly (and I mean directly) compete with for-profit companies? A fair list should exclude companies that narrow their services to help profitibility compared to gov't programs that keep broadened services for the public good (eg, the mailman comes to my house to check for letters and packages 6 days a week, but the Fedex guy doesn't.) Last thing, if for-profit companies are so great, why don't we hand over the federal gov't to them? Maybe give Google the White House?

 

[yakbladder]

One is mandatory for me to pay.

The other (like, say, Wal-Mart), I don't have to pay for if I don't want the product.

And with the postal system, if you don't like it you can use USPS. This isn't the end of private insurance. If private insurance is so dang efficient then they'll have no problems staying alive against this horrible government sponsored insurance, right?

I think a better way to look at this is that things are going to change. That is almost 100% certain. People can whine and moan and say this is horrible, we shouldn't do X, Y, Z but that almost never works on either side of the aisle. It would be far better, IMHO, to offer up some constructive suggestions for ways to improve what WILL change.

 

[BrianFromWA]

Or we could voice our vociferous dissent to the plan currently being discussed. As if to say "Don't waste your time trying to give me government insurance with illegal immigrant provisions--give me a bill with tort reform, so malpractice insurance premiums go down, so that medical costs go down."

That's one step.

 

[barfo]

Or we could voice our vociferous dissent to the plan currently being discussed. As if to say "Don't waste your time trying to give me government insurance with illegal immigrant provisions--give me a bill with tort reform, so malpractice insurance premiums go down, so that medical costs go down."

That's one step.

Except that many states have already enacted tort reform, and medical costs didn't go down. Oregon is one such state.

Studies show that what tort reform does do is increase insurance company profitability. Which is good, if you are an insurance company. Not so good if you are a guy who just got the wrong leg amputated.

The CBO also reports that it found no "statistically significant difference in per capita health care spending between states with and without limits on malpractice torts." In fact, the CBO found that malpractice costs only amount to less than 2% of overall health care spending.

The CBO report concludes: "the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency."

barfo

 

[BrianFromWA]

Thanks for the stats. Hadn't seen those.

I'd like to see why it's only considered 2%, and yet (anecdotally) each doctor I've asked says malpractice insurance is between 25 and 40% of their practice's overhead. Which indicates to me (who isn't an expert in medical costs) that if insurance premiums for malpractice went down, costs of seeing that doc would go down. Does that not make sense? Now, if the insurance company isn't passing the savings along, then that's another story. I guess I'd say "tort reform" to mean that malpractice insurance premiums would go down, since there is a cap to how much someone can get sued for.

And maybe it's just private practice docs hurt by this. And maybe it's changed a lot since 2001. http://findarticles.com/p/articles/mi_m0843/is_2_28/ai_84236557/

Indeed, Jury Verdict Research, of Horsham, Pa., reports that nearly half of all awards in medical malpractice cases topped $1 million in 1999, the most recent period for which data are complete. Simply settling a claim cost an insurer $650,000, up 30 percent in a single year.

* St. Paul said it paid out catastrophic sums -- more than $1 million -- twice as often in 2000 as in 1999: 54 cases versus 27.

* In 2000, a Philadelphia jury socked four physicians and two hospital defendants for $100 million for bad outcomes suffered by a baby born at 26 weeks of gestation.

* A Texas jury returned an $11 million malpractice verdict and a West Virginia jury tried to award $2 million to a plaintiff despite a state cap of $1 million.

Not surprisingly, these areas of the country have seen some of the most staggering rises in physician liability insurance premiums. PHICO bumped the price to Texas doctors 83 percent last year. West Virginia obstetricians paid an average of $75,155 in 2001, while their colleagues next door in Kentucky were charged only $41,661.

Faced with rates 20 percent higher in 2002 than last year -- already up as much as 60 percent over 2000 premiums -- "doctors are retiring early, relocating their offices to neighboring states or discontinuing their practices," complains Pennsylvania Attorney General Mike Fisher. "Hospitals are faced with the possibilities of closing trauma units."

Obstetricians, neurosurgeons, emergency physicians and other high-risk specialists have absorbed the brunt of the blow. It can cost an ob-gyn in South Florida $209,000 a year to insure for delivery of babies.

But even internists in some locales saw premiums soar last year by as much as 69 percent, and general surgeons by as much as 86 percent, according to a survey by the Medical Liability Monitor.

(In a few states -- New York, Michigan, Louisiana and Colorado, for example -- selected doctors actually enjoyed modest decreases.)

This one's from an article this year:

Physicians in specialties like neurosurgery and obstetrics can pay $200,000 a year for malpractice coverage in New York, though consumer advocates note that others pay less than a quarter of that and many are insured by the hospitals where they work.

So $200k is 2% of how much? That neurosurgeon's billing out $10M in work this year? Or that the "cheap ones" are costing 50k per year?

I guess I agree with this guy:

Arthur Levin of the Center for Medical Consumers said less than 2 percent of the entire cost of the medical system is from malpractice. "It's time to have what I would call sort or an independent forensic accounting of the industry's finances and its practices because something doesn't fit

after some more digging, this looks like it might be the missing part.

Richard Jennett, a specialist in gastroenterology at Jefferson City Medical Group, said the firm’s malpractice medical insurance premium was less than $1 million before 2003. But then the group’s rates began to increase by 20 to 30 percent a year, and there was a fear about whether the organization could even get insurance.

“We have a real good track record of providing good medical care and we were getting worried that we would have to shut our doors,” Jennett said. “That rate of increase was such that we would have had to stop hiring physicians or getting equipment. We were having trouble hiring doctors. Even some who trained in Missouri wanted to get out of the state because of the fear of excessive lawsuits.”

Since tort reform, he said rates have fallen 41 percent and more insurance carriers are willing to bid for the group’s business. He said the money that is not being spent on insurance has been used to buy a state-of-the-art CAT scan imaging machine and other machines to diagnose diseases and treat patients.

“And our ability to recruit physicians is clearly better,” Jennett added. “We believe it’s been favorable, and we don’t think it’s harmed patients.”

So basically, tort reform in Missouri DID do what it was supposed to: stop malpractice premiums from being so high that docs couldn't stay in business. Now that the premiums have dropped, they're not passing the savings on to the patient...they're charging the same high rates, but now buying state-of-the-art machines.

 

[barfo]

Thanks for the stats. Hadn't seen those.

I'd like to see why it's only considered 2%, and yet (anecdotally) each doctor I've asked says malpractice insurance is between 25 and 40% of their practice's overhead. Which indicates to me (who isn't an expert in medical costs) that if insurance premiums for malpractice went down, costs of seeing that doc would go down.

One would think so, but I think the lack of competition factors in here. Doctors don't have to drop their rates if their costs go down, because no one is competing with them on price. And insurance companies aren't obligated to drop the price of insurance just because their costs go down.

So basically, tort reform in Missouri DID do what it was supposed to: stop malpractice premiums from being so high that docs couldn't stay in business. Now that the premiums have dropped, they're not passing the savings on to the patient...they're charging the same high rates, but now buying state-of-the-art machines.

If you believe that guy, who isn't exactly an unbiased observer. I'll note that in the states where tort reform hasn't been enacted, doctors have not gone out of business. So either there is something special about Missouri (you'd have to Show Me what that would be), or this dude is exaggerating.

barfo

 

[barfo]

For what it's worth, I'm not against federal tort reform. But it doesn't look like it is anything more than a minor piece of the puzzle. It's not a corner piece or even an edge piece. It's one of those in the middle where there aren't really any distinct markings on it and you pick it up dozens of times and put it back down before it finally fits. And just then the dog runs in and jumps up and knocks the puzzle on the floor.

barfo

 

[Denny Crane]

Is the government taking over all health care in the U.S.? Honestly, work's been killing me, my one year old keeps me busy when I'm home and I'm admittedly out of the loop, but I didn't think this was the plan. So my employer won't have to worry about coverage for me and my family any more? I'd thought that portions would still be private and some would be covered by Uncle Sam.

If that's the case, then I can see your view for sure. Medicine that's completely socialized sounds like a train wreck to me. While the system is far from perfect now, I really doubt the government would be able to improve on it.

As I last understood it, consensus was that it would be a combination of old system (for profit) and new (subsidized by gov't). This thread makes it sound like it's a complete government take over of the healthcare system and, last I heard, that's a bunch of hooey. Like I said, maybe I've missed something over the last month.

Do I really think the government would do a better job providing insurance coverage for people currently covered by private insurance? No. I'd say let the for-profit companies work their capitalist magic.

Do you really think for-profit companies would have the ability (even interest to pursue a line of business) to provide coverage for people who currently can't get insurance because of pre-existing illnesses or can't afford it? This is the space that likely will need to be provided by the gov't or, at the very least, the gov't applying sufficiently powerful incentives and disincentives to for-profits to make it worth their while.

Maybe I'm wrong, but this thread seems like it's oversimplistic and designed to do nothing more than get people fired up in nonconstructive ways. Getting people fired up is cheap, easy and a waste of time. What we need is fair and honest communication that works toward solutions.

And anyway, how many gov't programs directly (and I mean directly) compete with for-profit companies? A fair list should exclude companies that narrow their services to help profitibility compared to gov't programs that keep broadened services for the public good (eg, the mailman comes to my house to check for letters and packages 6 days a week, but the Fedex guy doesn't.) Last thing, if for-profit companies are so great, why don't we hand over the federal gov't to them? Maybe give Google the White House?

It looks to me like the plan being pushed through the senate is designed to run the private sector companies out of business over time, leaving the govt. option as the only entity standing.

There are mandates with criminal penalties that everyone has to buy insurance.

While this thread compares the post office to govt. health care, the better comparison might be the education system. Here we have criminal penalties (truancy laws) that force people to send their kids (well, all but a few home schoolers) to public schools because the cost of private schooling is "expensive." The system is two-tiered, with the haves getting good education for their kids and the rest getting something considerably less.

The current bill is clearly a partisan one, as it exempts consituent voters and donors to the party in control.

What I think is that insurance is not what it should be. It shouldn't be covering every doctor's visit. It seems absurd to pay $300 or $500 per month, for the vast majority of people, so they can save $60 each on a small number of office visits.

What insurance should do is cover catastrophic illnesses and cases so people don't go broke if they need heart surgery and that sort of thing. If for the rest of treatment people negotiate directly with the doctors and directly pay the doctors, we would see capitalism do it's thing. That is, you can pay one doctor $95, or pay another doctor up the street $80. I don't see any reason they wouldn't compete.

If you go to one doctor and he seems to be running up the bill, you would go to another doctor and get a 2nd opinion.

 

[zєяσ]

The argument I always hear against single payer is that health care will be rationed or there will be long waiting periods; however both these things already exist and will continue to exist public or private. Currently, the system is rationed so only people who can afford it or who qualify for Medicaid can access it without going into horrible debt. I don't care much if rich people will still be able to buy better care and jump the line, but I want at least that the rest of us can get care too. The other argument I always hear is the fear of government bureaucracy. Again, the current system is already a bureaucracy. I would much rather deal with a government one because then I can hold my congressman and senators accountable at the ballot box. Also campaign finance reform would help plenty too. With so many lobbyists it almost seems the government is already privatized. Your insurance chooses to cover or not cover certain treatments and quite often the decisions on what is covered or not covered is not made by your doctor but someone in an office. The only difference is that in public care, turning a profit is not a priority. The current system has great health care tools, but only if you could afford it.

Another thing I hear is that everyone will be forced into the public system. Again, totally absurd. Every single European nation has universal health care and every single one has a thriving private health care industry, where people who have the money can go to get care (usually identical to public care, just with less waiting). I also find it strange that people can simultaneously think that public care is this awful third-world terrible medicine that on the other hand will completely wipe out private care if it is allowed to compete.

Now does this mean i support the current plans? No. I'm for a public option. But health insurance reforms proposed right now do not really address the issues. Sure, with the reforms everyone will probably be covered and companies cannot drop coverage due to pre-existing conditions, having mandates, and the like. But, the current proposals primarily focus on more care, not better care. What incentives do the companies and government have to improve health care for the citizens? How are we going to stop incentives for doctors to more and more care over the better care? Will there be cost-effectiveness research (the gang of six just made amendments to discourage that)? How will they ease the implementation of the new plan? Medicaid roles will grow because you are subsidizing more people and you will be covering people who did not have insurance before. Plus you gotta remember that consumers will have a hard time seeing the benefits because of taxes going up. You have to prepare the people for that don't you? And where the hell are the incentives for prevention? Isn't one cost-effective way is people not getting sick as much? I think that if we are living in a country where the government is allowed to tell us what to do at every turn and make laws for our own good the least they should be required is to offer basic health care to everyone. In that way I don’t think this plan is nearly enough. It would only make insurance available to more people. There would still be people who are uninsured, and just because you have insurance doesn’t mean you can afford the deductible much less your percentage of the extortionate bill. I guess a public plan may be a step in the right direction, but without that option it would be government mandated support of insurance companies. I do not believe it is the purpose of health care to profit off of one's suffering.

 

[blazerboy30]

And with the postal system, if you don't like it you can use USPS.

That is true for the USPS, but for many government programs, we don't have a choice whether to fund them with our tax dollars or not.

This isn't the end of private insurance. If private insurance is so dang efficient then they'll have no problems staying alive against this horrible government sponsored insurance, right?

Is there a strict stipulation that the entire government-run healthcare option must be at least profit-neutral? Will this be strictly enforced and upheld? If not, how could a private company that has to make a profit compete with a government program that can just keep feeding itself with tax payer money?

 

[blazerboy30]

For what it's worth, I'm not against federal tort reform. But it doesn't look like it is anything more than a minor piece of the puzzle. It's not a corner piece or even an edge piece.

barfo

What are the major pieces?

 

[maxiep]

An interesting stat I heard from Senator Michael Bennett in a town hall meeting was that if you wrung every cent of profit from insurance companies, it would pay for four days of health care in a year, or 1.09589%.

And yet there's a hue and cry for a public option, but not tort reform? Hmm.

 

[yakbladder]

That is true for the USPS, but for many government programs, we don't have a choice whether to fund them with our tax dollars or not.

So if I don't want to fund more than a meager Army to simply defend the homeland I can opt out of the rest of the defense budget? Or if I choose not to fund infrastructure investment because I don't care if roads and bridges crap out I can do that? Again, every person has a gripe with some portion of government / some agency. I understand the frustration that some people feel like government is everywhere but I think some perspective when comparing it to other countries who really are that way is in order.

Is there a strict stipulation that the entire government-run healthcare option must be at least profit-neutral? Will this be strictly enforced and upheld? If not, how could a private company that has to make a profit compete with a government program that can just keep feeding itself with tax payer money?

Since the final bill hasn't been signed off on I'm at a disadvantage to declare it one way or the other. But a non-profit coop would be, by legal requirements, held to that standard. Can you think of a government agency or program that is pro-profit? You seem to be, correct me if I am wrong, making a wild assertion that suddenly this government program is going to become this gigantic force independent of government control and laws, start sucking down money, going for profit, and living merely to target private companies. I simply don't think that is the case.