What If They Ran Health Care

July 30th, 2009 8:01 pm | by John Jansen |

Just a thought……….but if they cant run this enterprise what will it be like when the bureaucrats have a larger share of the health care pie?

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  1. 21 Responses to “What If They Ran Health Care”

  2. By IF on Jul 30, 2009 | Reply

    “They” already run healthcare. For “themselves”, for veterans and for old people. As long *you* can chose if you want *their* program or a private insurance, why complain? Competition is good. The more players the better.

  3. By John Jansen on Jul 30, 2009 | Reply

    How do you feel about vouchers for schools?

    The teachers unions and the folks who want “competition” in medical care are not so anxious to foster competition in the school system.

    And since the government does not pay income taxes or answer to shareholders it is not exactly a level playing field

  4. By IF on Jul 31, 2009 | Reply

    I have no opinion on the US school system. I think it is lunacy though to tie school financing to property taxes, but then again I was raised in Germany.

    Worse, I have fundamental issues with the concept of charging a 1 to 2 percent p.a. property tax on a house. This essentially means the local government owns 1/4 to 1/2 of your house, not the so called owner. (Imagine how far house prices still have to fall when accounting for this shadow ownership share.)

    To return to health insurance. While living in the US I always had fairly fancy insurance through (private) grad school and employer. Considering that I never really tested this insurance and that I can lose it anytime with my job, I prefer having a lower level of insurance that is *always* available to me. In Europe this is offered by the government. Not great, but dependable.

  5. By Byzantine_Ruins on Jul 31, 2009 | Reply

    Considering that I never really tested this insurance and that I can lose it anytime with my job, I prefer having a lower level of insurance that is *always* available to me. In Europe this is offered by the government. Not great, but dependable.

    IF —

    A good point to make here, although I generally agree with you, is that this isn’t “some country” it is America, which is truly some country.

    Imagine doing national health care the American way — Hughes is the contractor who issues the health care cards, which become the defacto national ID, except that the database never works even after a decade of promises. They want to give you a drug test before treating your hangnail, perform electronic surveillance of your health care or ‘anti-terrorism’ purposes that turns out to be anti-whatever-the-cops-want-today, you’re required to provide biometric proof of citizenship because the database is never working, and there’s a constant national debate over if and when the system can provide birth control as the American Taliban tries to rebrand rubbers as a form of abortion.

    Let’s not even talk about HIV care, the care provided to vistors from abroad, or women’s reproductive health in general.

    It’s not I have a problem with a national health bureaucracy, I just have a problem with an American one. This is the country that brought you Hurricane Katrina, the Patriot Act, the Invasion of Iraq and the TARP. Please understand why anyone who values their life would try to keep the monster away from health care.

  6. By Ken on Jul 31, 2009 | Reply

    I think the data in the article is wrong the amount of cars under the system is more and the reason they suspended it is because they reached thier goal in just 4 days. The article you use as reference is misleading.

  7. By Les on Jul 31, 2009 | Reply

    If the bureaucrats had been running the banks for the last 10 years, we wouldn’t have had the financial crisis the capitalists got us into and the taxpayer on the hook for trillions of dollars. I trust the post office and fire departments more than the people who ran the banks. Same type of people who gave us the S&L crisis of the 80’s. They didn’t learn.

  8. By Griff on Jul 31, 2009 | Reply

    Probably right,,,banks would have run out of capital a lot sooner. No MBA in his right mind would work at the pay grade, and banks would have been run like the DMV or post office.

    I don’t trust the post office with anything vital. $12 at FedEx is typically peace of mind.

  9. By Griff on Jul 31, 2009 | Reply

    You have your example of US govt run financial entities: Fannie Mae and Freddie Mac.

  10. By Gary on Jul 31, 2009 | Reply

    I think the constant reference to European government run health care as an example of a “successful” system is fraudulent.

    First of all, you can literally set your watch by when the trains come in Germany (I hear most of Europe, except UK — but I only have personal experience in Germany and UK). European governments, for whatever reason, seem to run trains well.

    In the US — we have AMTRAK. It is a disaster. Every 4-5 years, we get lied to again with another empty promise and another five year plan to make Amtrak self sufficient. This lie has been going on for almost four decades.

    Second, if anyone bothers to actually look at European health care — they offer less care than private plans here in the US, they have significant wait times for anything other than emergency surgery — and in spite of all that, they are still having trouble with controlling costs that rise much faster than their economies ability to pay for it.

    Costs that rise 9-10% cannot be paid for by an economy that grows 4-5% — no matter who the intermediary is (government or private). Obama’s plan doesn’t even try to confront this basic math problem. He is just robbing the future to pay for the present — Madoff style.

    Lastly, there is not ONE health care system in England — there are two. A private system for the rich, with the best doctors. And the public NHS for the rest. Its about as elitist as you can get — hard to see how anyone can call themselves a democrat and support that kind of system.

    BTW — Congress is already exempting itself from all the proposals. They want to keep their own private health insurance, which is already better than what we the people get now, and MUCH better than the plans Obama wants to force on us

  11. By Gary on Jul 31, 2009 | Reply

    It should also be mentioned that government run health care in both England and Canada has had cost control problems since they started. Both England and Canada have made up the difference by collecting royalties on oil — but England’s system is collapsing as oil revenue from the North Sea fields has peaked and can no longer keep up with health care spending… thousands of doctors have left the NHS and switched to providing private care only — as the NHS does not pay them enough to break even

    Wealthy Canadians have for decades traveled to Minnesota, Buffalo NY, and Rochester NY (that I know of) to get non-emergency procedures. After 9/11 and all the new passport restrictions, many wealthy Canadians are getting non-emergency procedures done in Thailand or India — combining the annual checkup with a vacation

    Everyone in the US can already get insurance. The problem is they cannot afford it. It is a cost problem, not an access problem. Obama is forcing a very poor “solution” to a problem that does not exist. Spiraling costs are the problem — and that is what must be addressed whether we have the DMV or private insurance processing payments.

  12. By Les on Jul 31, 2009 | Reply

    My wife is on Medicare. She says it is best health plan she has ever had!

  13. By John Jansen on Jul 31, 2009 | Reply

    Gary,
    Welcome back!

  14. By Gary on Jul 31, 2009 | Reply

    Les — your wife likes Medicare because she isn’t paying the bill for it. Your children are (or will). Even using government “accounting”, Medicare is actuarially bankrupt (has been for three decades), and will be cash flow bankrupt within a decade. Using GAAP, Medicare is already bankrupt. Robbing the future to pay for the present is not a viable system in the long run — and it is morally wrong to steal from our children.

    Obama himself (while attending the Apollo anniversary) lamented American’s lack of skills in math and science… anyone on this blog who actually manages a bond portfolio should see that -5% carry compounded year after year (10% health cost rise less 5% GDP growth) is guaranteed to go bankrupt.

    You have to be really really selfish or numerically illiterate to claim Medicare is a viable system

  15. By Les on Jul 31, 2009 | Reply

    We need to raise taxes to avoid your bankrupt scenarios. My taxes are way too low. We didn’t raise them to pay for Iraq war and and then Bush pushed through the largest entitlement increase in decades in form of Medicare drug program, and again didn’t raise taxes. Politicians love to spend and Americans want the benefits but don’t want to pay for them.

  16. By Clark on Jul 31, 2009 | Reply

    On-time performance of rail systems is not a good reference point for this debate. In Moscow there are signs above outbound tunnels in the metro system which tell how long it’s been since the last train departed. The performance target is that the last train depart no more than 3 minutes after its predecessor, and they hit that mark with admirable success. If they didn’t, society would collapse. The rest of Moscow is, as they say, “a bordello,” a favorite Russian word for utter chaos.

    Re: healthcare, the fact of the matter is we pay too much and a big problem is that poor people use ERs for primary care. Another is that there are no disincentives for ordering another test to provide marginally greater protection against malpractice claims.

    Jansen’s point about teacher’s unions battling competition in education is well-taken.

  17. By Gary on Jul 31, 2009 | Reply

    Les — a very partisan comment… the facts show Medicare was bankrupt long before Bush ran for Texas governor, never mind President. Hate Bush all you want, whine about Iraq all you want — but even if you convince Karl Rove of your views on Bush, it still wouldn’t make Obama’s proposals mathematically viable. Stealing from our children is wrong, no matter what your views on Iraq

    As far as taxes go, feel free to make an extra contribution if you like — but you are revealing your lack of math skills when you say raise taxes.

    There is no tax rate that can reconcile costs rising 10% while revenue rises 5%. A 100% tax rate still would not make that viable in the long run.

    Seriously, you have no business running a bond portfolio if that basic math is not self evident.

    Bush bashing doesn’t change any of the math the nation faces going forward — we cannot spend more than we make. Living beyond our means since the early 1960s (at least) has been the root problem behind all sorts of “crisis”, from the collapse of Bretton Woods to the current mortgage mess.

    Spending must be cut, or revenue must be increased. Since most people already try to maximize revenue, spending cuts are the only solution.

    Raising taxes on the young to pay for the health care of the elderly is another math impossibility. There are too many baby boomers, or too few youngsters. And those youngsters do not have high paying manufacturing jobs like their parents; most have lower paying service industry jobs. A small group making lower wages cannot pay for huge costs for a larger group…

    And raising taxes on the elderly to pay for the elderly is accounting smoke and mirrors. There is an administrative cost to Medicare — so just paying out of pocket will be cheaper by definition.

    At the end of the day — higher taxes doesn’t fix anything; at best it postpones the problem until after your death, sticking your kids with an even bigger problem. Long term, costs cannot rise faster than our ability to pay for them.

    Long term, health care costs need to rise no faster than GDP. That is just basic math.

  18. By Gary on Jul 31, 2009 | Reply

    Clark — I was simply illustrating that the US government has shown itself far less capable of managing big programs than European counterparts.

    Under both democrat and republican “leadership” — our government has been unable to control costs in basically every program. The military buys billion dollar airplanes, the state department buys $10,000 coffee makers, and FEMA buys millions of dollars of ice for Katrina survivors and has it shipped to Missouri (where it still sits). Medicare SG&A expenses are double the private sector while Medicare fraud is three times the private sector.

    Both the post office and Amtrak regularly trot out Mao like “five year plans” for self sufficiency — and they fail again and again and again.

    Don’t even try to defend the stupidity that is the DMV in every state in the nation.

    US health care is a mess, and desparately needs reform, but as doctors like to say “First do no harm”. Suggesting the US government can make the health care system better without rationing is absurd

    And that’s before we bring up legal issues like trying to force Christians to pay for abortions. Just remember, if you abuse the power of the state to force your religious beliefs on them, they can force their beliefs on you. We have freedom of religion for a reason.

    Then we have euthanasia issues. Supposedly half of all health care spending is in the last few months before death — so the issue of when to pull the plug cannot be avoided. After seeing Congress meddle with that lady in Florida two years ago — how can anyone seriously suggest putting them in charge?

  19. By Les on Jul 31, 2009 | Reply

    Gary-You must fancy yourself as a mathematician!
    You wrongly assume I am a portfolio manager. My math was good enough as a trader of government securities to retire at age 51. I am just to the right of Atila the Hun on political sprectrum. I don’t see any major difference in the parties on taxes and spending. You need to stop impugning peoples math skills!

  20. By Gary on Jul 31, 2009 | Reply

    Les — Obama was actually the one who mentioned poor math skills first (although I agree with him). If you are telling the truth and you retired at 51, I have to wonder how that would be possible if your trading book had -5% carry per year.

    I agree with you 100% on both parties being a disaster on taxes and spending. I complained about Bush bashing because how ever many mistakes he made — its water under the bridge. Bush inherited problems from Clinton, who inherited problems from Reagan, who inherited problems from Carter, etc, etc.

    A real leader knows they have to play the cards they are delt, not the hand they wish they got. Obama knew Bush was president when he ran for office, all this “inherited problem” nonsense is childish.

    We all agree the country is in a mess — real leadership would guide people on what to do going forward rather than whining about yesterday’s mistakes.

    Going forward, we need to live within our means. Yes, that is basic math

  21. By Gary on Jul 31, 2009 | Reply

    BTW — five minus ten is not complicated math, and I don’t need a PhD in math to know that is a losing game. We are talking elementary school math here.

    That politicians and so-called “analysts” are trying to make -5 sound like a positive number — and so many citizens are actually buying into this con game, should be an embarrassment to us all

  22. By Gary on Jul 31, 2009 | Reply

    The CBO (controlled by Congress, which is controlled by Obama’s own party) has come out saying the costs of Obama’s plan will be much higher than Obama claims … in other words, I am not the only one complaining about poor math skills.

    And on the subject, Obama says health care spending is 18% of GDP (and other sources say the number is somewhere between 15% and 18%)…

    So why does the BLS weight healthcare spending at only 6% of CPI ???? Here is a cost that is rising twice as fast as the economy is growing, but CPI drastically underweights it. This sort of dishonest accounting (aka “math”) is how the economy got into such a mess.

    Lets talk about recent corporate earnings announcements… Excluding “one time” costs (which seem to happen regularly), asset disposition costs, and the cost of laying off staff — operating earnings are up even though revenues are flat! Earnings before expenses? What kind of dishonest math is that?

    As long as poor math (I was being charitable here, I think its just plain dishonesty) is the law of the land — the economy is not going to recover for real

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