Thanks for summing it up so well Leaki- it's refreshing to be able to agree on something once in a while!

Likewise.

I am not an automatic anti-Artysim machine.

Most of my opinions are based on having been there while it happened. I lived in both a country with a complete public healthcare system (Germany) and a country with a mixed system (Ireland). I prefer the mixed system but that is because I can afford it.

No, Monopolies and Monopsonies are.  The reason you cannot cite costs is for the same reason Artysim cannot.  it is hidden.

There is a saying in government - throw more people at the problem.  The reason being - the cost is invisible.  The people are going to be paid regardless, so whether they do something productive, or stupid, does not matter - the money has already been spent (have you heard of governmnet layoffs?).

There is no way when your social budgets dwarf the US that you can convince me it will be cheaper.  Not that you are not trying, but simply because it is not possible. (to prove).

The above is a muddy point since an American in Canada may have to do the same since we arent covered by your system.Basicly the American or the Canadian visitor has to purchase special travel insurance.

I am not sure why people are so excited about the idea of making healthcare "cheaper". 

I'm not interested in healthcare being cheaper. I want it to be of the highest quality that I can afford.

I'm not interested in having to pay for other people's health care through my tax dollars.  Look at public schools. I don't want that sort of thing being done with my health care.

Monopolies and monoposonies are not exempt from the laws of supply and demand. They just represent spikes.

The reason YOU cannot cite costs is because you think an anecdote about toilet seats is an argument. It isn't. It doesn't even occur to you that IF you are right about the invisibility of costs in a public healthcare system, neither of us will be able to tell what that cost is. But nevertheless you think that after demonstrating (if you were right, which I doubt) that the cost is invisible, you have somehow shown that it is high. But that's not true.

If you are right about the invisibility, then neither of us can tell how much it is.

But _I_ can tell, from living in a country that has a public healthcare system, that the cost is not as high as you think it is and certainly not as high as the profits that a private healthcare system produces.

I'm not sure either, but I don't think anyone has argued that cheaper is better. I am merely stating that a public healthcare system is cheaper, not that it is better because it is cheaper.




Everyone wants that. But not all people can afford the best. A private healthcare system is no doubt better for those with a good income. I for example profited immensely from more expensive and better dentistry than I could get in Germany. My dentist now costs me ten times more than my dentist in Germany, but he teaches at Trinity College and actually FIXED everything, which the German dentist failed to do.

For me that was excellent.

For someone who just cannot afford my current dentist, it's useless. That someone would have to rely on a dentist paid for by the public healthcare system who is as good as the share of money the public healthcare system can get from the entire amount spent on healthcare.

Question is, should I have a dentist at level 10 when others have a dentist at level 5 or should everyone have a dentist at level 7?

I am for my level 10 dentist. And I pay for that privilege. Others are free to make as much money.

But that doesn't mean that I have to defend my choice by making up stories about the inefficiency of government (which I have seen isn't true) or the costs of a public healthcare system (which I know is less than the costs of a private healthcare system).

If a private healthcare system is better, it should be possible to make that point based on its actual attributes rather than to rely on transparent lies about the alternative.




I am a product of the German state school system. I don't consider myself that stupid.

But I did attend a private college for two years and the fact that it cost me money actually made me work harder and get the diploma; something I failed to on a state university where the entire infrastructure was built to support long-term students who still don't have a job when they are 31.

I certainly don't want to see what would happen if those state schools were to be replaced by (you would call them) private schools that not everyone can afford. Boy would that help if the children of Germany's unemployed were no longer under state control during at least their time at school! Their parents would have such an excellent influence on them and I am sure they will pick (and pay for) the right school.... not!

My experience tells me that state schools are the way to go before the college level. But a college education should cost money (prospective students can surely work a year or two to pay for it; I did). I found that I work harder and get better results when I pay for it myself.

(To avoid confusion in later replies where I might not pay attention I should add that in British English a "state school" is a school run and paid for by the state while a "public school" is a privately owned school open to everyone who is willing and able to pay the fee. Thus in British English a "public school" (BE) is what Americans would call a "private school" (AE). The word "public" is here used as in "public company" or "public house". A "public school accent" is an Upper-Class British accent.)

Leauki, hammers and toilet seats are anecdotal - you're right.  Those anecdotes go to demonstrate the point that government (and the U.S. Government, in particular) is an inefficient, bloated, wasteful entity.  Nothing that is done is done efficiently.  When some of the largest (and highest profile) Army contracts are to streamline business process and then, utilizing the same methodology as business are still only half as efficient as the private sector (again - using the EXACT SAME methodology), there's a problem. 

I work as a federal government contractor.  I work in a federal facility, side by side with civil servants.  I see all kinds of waste and inefficiencies going on around me, every day.  When a simple request has to go through the hands of 10 different people before it gets from my desk to the guy 3 desks down ... that's a little wasteful.  When it takes 3 weeks to process the paperwork (and 5 different people have to look at it) to EVALUATE the need to EVALUATE a leaky roof, there's a problem.

In theory, a government should be more efficient than multiple business entities performing the same task - just because it's one entity rather than multiple.  In the US - it ain't happening.  Too many little fiefdoms (at all levels) that have to be protected to be anything close to being efficient.

I work as a private company contractor.

I have worked for universities and hospitals (state-owned) in Germany and private companies in Germany and Ireland. (I was also sometimes an employee.)

I have seen waste and inefficiency mostly in private companies, to very ridiculous extends that dawrf all the stories I have heard about government incompetence.

Yes. However these things happen in private companies too.

(Perhaps you should read the Daily WTF to get an idea.)

The reason you see it in government is because there is fewer of them and they are more transparent than companies. Companies are both better and worse than governments, simply because there are more of them. Some are bound to be more efficient than government and that's the ones we compare government with. (Which is a good idea since we would want government to be more like them.) But some are bound to be worse than government and we never compare government with those (and for good reason too).

Arguing against public healthcare based on the argument that government is less efficient than the better companies is as fallacious as argainst against private healthcare based on the argument that government is more efficient than the worse companies. Statistically, private companies are both better and worse than government when it comes to efficiency. (You get the same result when you compare one apple to many apples. The one apple will be worse than the best apple and better than the worst apple. It's unlikely that the single apple will be one of the extremes.)

There is nothing inherent in government that makes it more or less efficient than private companies.

 

In the world that may be true, but in the US Gov, every policy has to withstand constitutional muster.  That may not sound like a big deal, but our laws have gotten so convoluted at certain levels, that the reason 5 people have to look at one thing is because each has their very own specialty.  Which means at some point, somewhere, the easy way of doing it was challenged and found to be problematic when filtered through everyone's rights.

In a private business, the bottom dollar is the motivating force.  Makes things much simpler. 

Imagine running the same business but with all the laws and criteria governing spending the public's money.  Every time you write a check ten people have to look at it to make sure the payment isn't violating some obscure rule, and then half of them have to make sure the record keeping is meticulous because its not their private money to be spending and they better account for every cent.

All it takes is for some specialty group to sue the gov, and even if the don't win in court, policies regarding paperwork change just to avoid the same issue later.

Other governments have the same problem. Particularly Germany is famous for its bureaucracy and I can tell you from my own experiences that Ireland and Israel can be even worse.

 

In my experience the quest to save a penny causes many companies to have even more ridiculous rules than government agencies, which at least try to confirm to certain guidelines (no matter the cost).

I have seen companies risk their entire future (and lose it) because the procedure to buy a _network cable_ was so complicated that few systems administrators wanted to risk having to write a business case for replacing an old cable.

And while such companies generally don't survive in the market, I fear that healthcare is not really a market in which the death of a company is an acceptable casualty. I want to _know_ that my insurance company will still exist when I need it, even if run by idiots; but the knowledge that my insurance company, if run by idiots,  WILL not survive because of the market weeds out the weak is not as comforting. (Government run by idiots does survive.*)

 

That's pretty much how IT equipment was bought in the last company that employed me (I am a contractor now and have been for years).

The only exception is that the record keeping was not meticulous because replacing the non-working backup system (consisting of broken tape drives and scripts that were meant to backup servers that didn't exist any more) created costs subject to writing a check.

 

Specialty groups also can and do sue private companies.

 

*After World War 2 all those German citizens who had pensions saved up in private banks lost their money (when private companies were reorganised), but those who had their pensions with the government received their actual pension (including Lithuanian Nazis who worked for the German government for two years). Turns out private companies WILL use a way out of responsibilities, while a government run by the greatest idiot in the world is still a reliable trade partner.

 

This brings up a very interesting topic that hasn't received too terribly much attention in the last few years- that being, the fact that massive amounts of public money (your tax dollars) going to private hands (lucrative government contracts) due to the fact that the government is essentially at war with itself.

What does this mean? The current popular line of thought is that since all governments are wasteful and inneficient, they must streamline their operations by outsourcing as much as possible to the private sector. In some cases, this makes things more efficient and in many cases it ends up enriching the contractor while INCREASING the waste and inneficiency. Although the same work is now being done by a private contractor, it ends up falling back on the government's lap and making them look even more wasteful and inneficient.

In essence, this creates a self fulfilling prophecy and a vicious cycle that is self-perpetuating.

As an example, let's look at hurricane Katrina-

Technically, FEMA and the various government's involved were responsible for reconstruction and damage control- but, since they're big bad government agencies who are incompetent, the argument of the day was "contract out to the private sector!" This meant you had government agencies handing out contracts to companies that subcontracted to someone who sub-sub contracted and so forth. It worked out that at the end of the day the government was paying something like a hundred dollars per so many square feet of tarps to be laid over roofs- and that's purely labor costs as the government already owned the tarps and was contracting out for labor alone.

This example has been replicated over, and over and over again.

Current ideology states that government is wasteful and inneficient, so they should let the free market take over. So, government contracts out a necessary job to private company (at a profit for the company of course) company, wanting to maximize profits then sub-contracts to someone who'll actually do the work and employ real bodies to do things, for the least amount of money. So the primary contractor is essentially just taking a big chunk of money, taking their cut, then passing on a much smaller amount to the people actually doing the work. For maximum effect the money can pass through several companies before any actual work is being done.

This then leads to the government outsourcing a function to the private sector and paying 500 dollars in labor costs so that a toilet seat (which the government already owns) is installed by a guy making 7 bucks an hour. This makes government look terribly inneficient (Which it is when this happens) which then causes calls for FURTHER outsourcing and further contracting out, which will then make the government look even more innefficient!

The end result is

A) Poor quality of work as it's often being performed by the guy at the bottom of the pyramid, making peanuts

Big profits for private companies that were initially awarded the actual contract from the government

C) Massive amount of public money going into private hands

The only exception to this rule is A) as in the high-tech fields that are outsourced properly qualified and trained folks refuse to work for peanuts!

The National Parks and Forestry Service.

 

 

 

 

I'm kidding.

Anyone that has dealt with the US military health care system, would IMO have had a glimpse into what national health care would be like. Are there good military doctors, sure along with the hacks. The most prescribed pharmaceutical? Motrin along with a 24 bed rest chit (ask anyone that's been there, it's a running joke). All three of my children were farmed out to the civil sector when they were born (not complaining, glad it happened). I remember feeling sorry for the retirees camped out in the waiting rooms, probably waiting patiently hours, just to get their Motrin. Ha that's me now, except I get Naproxen (Aleve is the commercial name).

Leauki, many thinks I do agree with you on, but you'll never convince me the gov. can do it better, not here in the US anyway (seen it happen too often, too long), I'll trust your experience in Ger., Ire., and Israel.

Wow! Artysim I find that I agree with you on this! See, liberals and conservatives can co-exist!   

No, they do not.  And it is not a conspiracy, but the fact that the law cannot work when competition does not exist.

I cited no anecdotes.  I only cited established teachings of the laws of Supply and Demand, and known facts about the operation of government.  You are free to challenge either, but I dont think you will find empirical data to support it.