Ownership?

[Crissa]

This IS a joke, right?

Some government services are super-efficient compared to private versions: Health care, infrastructure, military. It varies wildly by type of service and charter.

-Crissa

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[FutureBoy]

Some government services are super-efficient compared to private versions: Health care, infrastructure, military. It varies wildly by type of service and charter.

-Crissa

Plus where business is super efficient is in providing a specific product or service for a price and then building a moat around itself so that competition gets stifled.

Business is not so efficient at addressing greater good necessities (ending hunger/homelessness, care for elderly or disabled), blue sky research (human genome project, DARPA projects, virus research, carbon emissions effects), shared infrastructure (interstate highways, internet creation), or creating level playing fields (anti-trust, interstate commerce).

Business has its place. But so does government. The largest problems tend to happen when either side steps out of their own wheel house or when either side abdicates their own role in some way. And the people need to be actively doing their role of providing checks and balances. Right now I don’t see many people actively taking on that role.

 

[ajdelange]

...when either side abdicates their own role in some way.

One's perspective is doubtless influenced by his experiences I suppose. I live and worked my entire career in the DC area. I got to rub elbows with lots of government. You folks would not believe the incompetence, stupidity, veniality and self serving focus of your average civil servant. Now I must add here I have known some fine men who worked for the government. Most of them eventually get to the point where they can't stand it any more and leave. I should also add that I read Ayn Rand as a young man.

When a company doesn't do what it is supposed to do it loses money and eventually goes out of business. When a government agency doesn't do what it is supposed to do (and this is universally the case from what I have seen largely because political correctness is more important than mission) it goes whining to congress that it needs more money and usually gets it. Thus a good analogue for government is cancer. Its only goal is to grow even though its growth eventually kills the host.

 

[azjohn]

One's perspective is doubtless influenced by his experiences I suppose. I live and worked my entire career in the DC area. I got to rub elbows with lots of government. You folks would not believe the incompetence, stupidity, veniality and self serving focus of your average civil servant. Now I must add here I have known some fine men who worked for the government. Most of them eventually get to the point where they can't stand it any more and leave. I should also add that I read Ayn Rand as a young man.

When a company doesn't do what it is supposed to do it loses money and eventually goes out of business. When a government agency doesn't do what it is supposed to do (and this is universally the case from what I have seen largely because political correctness is more important than mission) it goes whining to congress that it needs more money and usually gets it. Thus a good analogue for government is cancer. Its only goal is to grow even though its growth eventually kills the host.

I completely agree and my wife is a government worker, I know the issues

Government should stay out of the health care field, they have enough problems getting out of their own way. When I lived in Arizona I had 2 different Docs that left general practice because they had enough with The Affordable Care Act and went to weight loss medicine which is cash only and doesn't involve insurance.

The Government doesn't like to pay their bills. The Canadians I have known use to tell me socialized medicine is ok for maintenance but if you need procedures done they come to America or Mexico and pay cash out of pocket

 

[Luke42]

That's a great question and one that I believe should be studied. There was a study not long ago that indicated Americans pay more than 50% of there income in some sort of tax - income tax, death tax, sales tax, property tax, etc... I'm not sure if those same things apply in those countries.

It's really not that hard to study on an individual level.

Just ask your HR department to tell you now much it costs to employ you (your "encumbered" salary).

You divide that by your take-home pay, subtract it from one, and multiply that by 100. That is your *effective* tax rate, with no distinction made between "private taxes" (health insurance premiums) and government taxes.

Effective_tax_rate = 100 * (1 - $take_home_pay / $encumbered_salary)

You can spend a lot of time increasing the precision by removing useless perks from the big number but, since the bulk of the number is going to be health care and retirement, getting down into the weeds won't make a huge difference in the final numbers.

When I ran that number, I found my effective tax rate to be pretty similar to these "scary European tax rates" that conservatives were using to scare me into staying conservative.

Their argument completely unraveled when I failed to make a distinction between private "taxes" and government taxes -- but, no matter who administers the program, it's still money I earned and didn't get.

The difference is the value I (and my neighbors) receive for my money. I'm receiving less value for my money than, say, a British citizen -- but a big chunk of that goes to private health insurance instead of the NHS, which muddles the numbers.

As a result, I've decided to insist on getting a good value for my money, instead of insisting on paying the minimum amount. As anyone who's ever engaged in any capitalist endeavor knows, the lowest price is not guaranteed to be the best value. I insist on getting the best value for the money removed from my paycheck.

 

[FutureBoy]

One's perspective is doubtless influenced by his experiences I suppose. I live and worked my entire career in the DC area. I got to rub elbows with lots of government. You folks would not believe the incompetence, stupidity, veniality and self serving focus of your average civil servant. Now I must add here I have known some fine men who worked for the government. Most of them eventually get to the point where they can't stand it any more and leave. I should also add that I read Ayn Rand as a young man.

When a company doesn't do what it is supposed to do it loses money and eventually goes out of business. When a government agency doesn't do what it is supposed to do (and this is universally the case from what I have seen largely because political correctness is more important than mission) it goes whining to congress that it needs more money and usually gets it. Thus a good analogue for government is cancer. Its only goal is to grow even though its growth eventually kills the host.

I completely agree with you about how government is run. I see that as a natural extension of human nature. Everything we see in life needs to have checks and balances. And the check for government is supposed to be the people. We are the ones who are not performing our own duties. We do not insist on government transparency. We do not use existing transparency to learn about what is actually happening. We do not educate ourselves about how government works or the history of how we got to where we are. And when circumstances get so bad/out of control that there is clearly a problem, most of us just sit back and complain about it to our neighbor. It is the responsibility of everyone to be involved and do the work of providing feedback, checks and a balance to government. But mostly we are lulled into ignoring everything till our own house is on fire.

 

[Cyber]

The Department of Veterans Affairs hospitals and clinics that I've frequented are abysmal. It's an anecdotal data point, but I wanted to add it. They're so terrible that I elect to pay for private health care insurance.

 

[Crissa]

When a company doesn't do what it is supposed to do it ...

Money and doing what it purports to do are not the same.

Lots of companies don't do what they set out to do but still make money.

The Department of Veterans Affairs hospitals and clinics that I've frequented are abysmal.

And yet, your statement is contrary to the median experience. The VA has better satisfaction levels and longer life outcomes than private medicine. Not to mention cheaper.

-Crissa

 

[FutureBoy]

The Department of Veterans Affairs hospitals and clinics that I've frequented are abysmal. It's an anecdotal data point, but I wanted to add it. They're so terrible that I elect to pay for private health care insurance.

From what I’ve seen the VA has some varying levels of service and care. In the relatively recent past there were news stories of neglect and abuse plus years long waits for service. And some of my relatives relate their hatred of the VA for various reasons.

My personal experience walking my dad though the VA for a few years of regular appointments and care as he progressed through dementia and finally passed we’re not that bad. The appointments were punctual, most of the interactions were cordial and caring, and most services were helpful. There were a few bad apples along the way. There was a real need to keep control and plan out various steps. And there were some services that were denied in a catch 22 process.

I could imagine that for someone that had PTSD or other non-obvious or demonstrable conditions it would be a very difficult process. Plus if one were declining in functionality but had no one to help, it would be a heavy lift. Or if one had little to no resources, it would be easy to fall through the cracks.

The alternative though for most of those same situations in the private sector would be high cost, or getting passed off to multiple other providers, or emergency room care that would be disjointed, rushed, and out of context.

Overall the US just doesn’t do a good job of caring for the least of our brothers / sisters.

 

[ajdelange]

We have a close friend that was an infectious disease specialist working for the VA for years. She would confirm that it looks as bad from the inside as the outside.

 

[Luke42]

The Department of Veterans Affairs hospitals and clinics that I've frequented are abysmal. It's an anecdotal data point, but I wanted to add it. They're so terrible that I elect to pay for private health care insurance.

The VA really helped my dad out near the end of his life.

He was not proud of his service (Vietnam-era draftee), and he avoided the VA as long as he could. His experience as a draftee is something which kept me, and likely his grandchildren, away from the military.

But the VA really came through for him when he needed them most. His service did have an upside, after all, and former soldiers deserve to have it as an option.

 

[Luke42]

We have a close friend that was an infectious disease specialist working for the VA for years. She would confirm that it looks as bad from the inside as the outside.

Everybody's workplace is a shitshow when viewed from the inside, though.

Even the most world-changing place with a gold-plated reputation where I worked was that way. And, less surprisingly, the opposite end of the spectrum was one, too. The difference is how well we-the-responsible-employees cleaned up the shitshow.

 

[Frank W]

I know first hand what it is like. There are some good places (much newer) as well as some that look like nothing has changed since 1980 sadly. You have to feel sorry for the patients that don’t have any other choice for their healthcare needs.