Aetna CEO To Justice Department: Block Our Deal And We'll Drop Out Of Obamacare

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**Ouze**

Boy, I sure wish we had gone single payer.

**JohnHwangDD**

Ouze wrote:
Boy, I sure wish we had gone single payer.

Same. It's the only rational way to provide basic care to everyone.

**tneva82**

JohnHwangDD wrote:
Ouze wrote:
Boy, I sure wish we had gone single payer.

Same. It's the only rational way to provide basic care to everyone.

Then again if you have monopoly what motivation you have to ensure you have quality or cost efficiency...

**JohnHwangDD**

tneva82 wrote:
JohnHwangDD wrote:
Ouze wrote:
Boy, I sure wish we had gone single payer.

Same. It's the only rational way to provide basic care to everyone.

Then again if you have monopoly what motivation you have to ensure you have quality or cost efficiency...

Right now, we have neither, whereas every other single payer system pays less per capita for better care.

**Peregrine**

tneva82 wrote:
Then again if you have monopoly what motivation you have to ensure you have quality or cost efficiency...

Altruism? On the other hand, what motivation do you have to decrease quality or efficiency? The problem with private health care is that the people who benefit from the quality and efficiency incentives are the shareholders of large corporations, not the people who need health care. The incentive is to raise prices as much as possible without losing too many customers (after all, what are you going to do, decide not to get that cancer treated?) and deny as many insurance claims as possible. If there's any savings in efficiency they sure aren't going to be passed on to the average person. And this happens at every level of the process: doctors, hospitals, drug companies, basic supplies, etc. Someone has to make a profit from every part of health care, which pretty much guarantees that you're not going to be getting the best possible deal for the average person.

And then there's the "insurance pays for everything" problem where the system actively rewards inefficiency. Say you're a doctor. You know that most of your patients are covered by insurance, so they're paying the same fixed price no matter how much you charge for your services. So why charge $100 for a thing when you can charge $1,000 for it? Sure, the insurance company will eventually pass on the price increase to their customers but it's not like they can really choose to stop paying. The end result is that there's a lot of stuff that costs obscene amounts of money in the US compared to what it costs in other countries.

**tneva82**

Peregrine wrote:
Altruism? On the other hand, what motivation do you have to decrease quality or efficiency?

Fill up own pockets? Charge up more or do less while charging same. No competition so no need to worry about customers going elsewhere. You see good examples of how inefficient monopolies are in Finland. Wherever there's goverment ran monopoly in Finland you know customers are getting screwed.

**Peregrine**

tneva82 wrote:
Fill up own pockets? Charge up more or do less while charging same. No competition so no need to worry about customers going elsewhere.

But if the government has a monopoly on health care then there is no incentive to profit. Nobody running the system gets any personal benefit from it, any "profits" the system makes would just disappear into the government's general budget. And there certainly won't be any bonus checks for employees who manage to increase "profits". In fact, you might get fired for finding a way to increase "profits" without immediately passing the savings on to the customers.

Automatically Appended Next Post:

tneva82 wrote:
You see good examples of how inefficient monopolies are in Finland. Wherever there's goverment ran monopoly in Finland you know customers are getting screwed.

But how does this compare to customers getting screwed by private industry's profit motives? And to the inefficiency in the private industry system that I pointed out?

**Do_I_Not_Like_That**

I cannot believe that Lord of Deeds thinks they are 'death panels' in the British health system...thats..just...

I remember that Fox News story about Stephen Hawking being killed by a 'death panel' but lo and behold, Hawking is alive and well...

You don't honestly believe that millions of ordinary Britons like myself would tolerate that?

But to be fair, some reasonable points were made, especially regarding middle men..

If I had the choice between a private company middleman, and a government middle man, it would be the government middle man any day of the week...

Why? Becuase as a voter you have more influence on government than you do on a private company...

In saying that, I refuse to believe that a country like the USA, rich, technologically advanced, and full of smart people and top universities, cannot make a better health care system for its people...

**Mozzyfuzzy**

That's because you can just pull up your bootstraps and then have the money to get the best care..... or something.

**tneva82**

Peregrine wrote:
tneva82 wrote:
Fill up own pockets? Charge up more or do less while charging same. No competition so no need to worry about customers going elsewhere.

But if the government has a monopoly on health care then there is no incentive to profit. Nobody running the system gets any personal benefit from it, any "profits" the system makes would just disappear into the government's general budget. And there certainly won't be any bonus checks for employees who manage to increase "profits". In fact, you might get fired for finding a way to increase "profits" without immediately passing the savings on to the customers.

They can charge up more.

But how does this compare to customers getting screwed by private industry's profit motives? And to the inefficiency in the private industry system that I pointed out?

If one company screws customers too much customers can vote with their wallet and go elsewhere...Why pay X for worse service if another company offers better service at 90% price? Keeps companies at least from total screwing of customers because they would LOSE those customers. I sure as hell won't go to worse company "just because". Quality can be determined in advance fairly often and price is obviously well known in advance.

**LordofHats**

Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

**jmurph**

So, AETNA and other big insurers pushed for ACA hoping for captive markets and made sure that their wouldn't be any meaningful competition between states. Now, when they don't get these mega mergers, they want to take their ball and go home. So let them.

Just shows yet another reason why relying on parasitic insurance companies was a bad idea.

**Do_I_Not_Like_That**

LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

**Ketara**

Just read this. I found it interesting how the American doctors first reaction was one of dread. Does the NHS really have that bad a rep in America? You hear the odd horror story here and there, but generally speaking, every interaction I've had with the NHS was satisfactory, y'know?

https://drjengunter.wordpress.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/

You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital.

Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind outside of Westminster Abby. He was complaining enough to let me flip his eyelid and irrigate his eye on the square in front of Big Ben. (I’m sure several people thought I was torturing him). Despite an extensive search and rinse mission no object or relief was to be found. I fretted about going to the hospital. It wasn’t the prospect of navigating a slightly foreign ER, but simply the prospect of the wait. While I am a staunch supporter of the British NHS in the back of my mind I envisioned a paralyzingly full emergency room and an agonizing 18 hour wait only to find he had nothing in his eye (the basic antechamber of Hell scenario). To ensure we really needed to go I gave Victor a choice between the emergency room and a toy store (Gunter’s 3rd rule), but he declined the toys so off we went to St. Thomas hospital, conveniently right over the bridge.

The hospital was on the aging side and a little drab, but clean and well-marked. I didn’t have to ask anyone for directions. We had to take a number to be registered, but waited less than 5 minutes. I gritted my teeth a bit in preparation for the we-are-not-from-the-UK conversation, but it wasn’t an issue at all. I offered my US insurance number for billing, but was told they didn’t need it. The clerk was, however, impressed with the fact that I flipped his eyelid and irrigated his eye before coming. “Well, you did all the right things,” and looking at his red and watering eye she smiled and said. “Looks like you are in the right place.”

Registration completed, we waited to be seen by the children’s part of the ER. A registrar (resident) did a quick triage within 5 minutes of our registering (also impressed with the eye irrigation) and then a nurse did his vitals and took a history. After that we waited less than 15 minutes for the registrar to do a formal assessment. He wanted ophthalmology to do the evaluation. I was a bit surprised the ER doc wouldn’t do it, but every facility is different and when they found out that Victor was born at 26 weeks and had retinopathy of prematurity they got a bit jumpy. Everyone does. I was ok with ophthalmology checking him out. What I have learned from years of medicine is don’t mess with the local order.

We were walked over to the urgent care clinic and were warned that the ophthalmology registrar was covering the whole hospitalIMG_8897 so it might be a while. This was our longest wait, about 20-30 minutes. She was very nice (also working on her PhD). Dr. Katie Williams (she gave me permission to use her name and her photo) diagnosed Victor with a corneal abrasion and easily snagged the offending speck of dirt wedged under his eyelid. Once removed Victor exclaimed, “It’s gone!,” and within a minute or two the redness cleared up. She put in antibiotic ointment and gave us a tube to use at home.

“So where do I pay?” I asked Dr. Williams.

The answer: you don’t. Perhaps they might bill us, she just wasn’t sure.

I was about as dumbfounded at her answer as she was at my asking.

I protested that it wasn’t fair. We had used services and I was very prepared to pay. I also have insurance that covers emergencies when out of network, so I was pretty sure I would be reimbursed at least some of the visit. However, we were just sent away. They do have my address so it is possible I will get a bill in the mail.

I am very curious what similar care would have cost in the US. The saddest commentary of all is that it is really impossible to tell as billing practices are so bizarre and opaque. My guess is it would be a minimum of $1000 in America for cash (which is egregious). If I ever get a bill from the UK, I’ll post a follow-up. If anyone has had similar care in the US and received a bill please do post in the comments. You can remain anonymous if you like.

But what of this idea that national health care means DMV-purgatory worthy waits, Dementor-staffed death panels, Saxon-age medical equipment, and incompetent care? Well, I can tell you we had great care at St. Thomas and Dr. Williams was fantastic. The slit lamp wasn’t brand new, but it worked just fine. Sure it’s an N of one, but I’ve been to the ER more times than I can count with my other son and this was as smooth as the best care we’ve had in the United States.

We could have hit the ER at an opportune time, but to expand my N I’ve also asked many people about their medical care while I’ve been in the UK. Not one person wanted to abandon the NHS. I’ve heard of excellent care and some care that was lacking, but the bad care has nothing to do with the “national” part. Rather it was diagnostic errors or a full hospice unit, things that I hear about with the same incidence back in the world of commercial insurance. Take away the accents and I could easily have been listening to a group of Americans discussing their care. With one exception, no one in the UK is left wondering what the price will be or gets an egregious bill.

It makes you wonder exactly what frightens Americans about the NHS?

**djones520**

Well, that whole strike thing that happened in the NHS recently? That didn't exactly get good press over here.

**whembly**

Do_I_Not_Like_That wrote:
LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

Ideally... yes. The Federal government becomes empowered to raise taxes, then 'block grant' the money to the states 'run/administer' the services.

What gets sticky, is determining what will be covered as necessity and what is elective. Who determines that?

Best way would be to let the state decide, but knowing some folks, they'll want the feds to mandate 'you must include these things in order to recieve these grants!'

**Mozzyfuzzy**

@djones

That was the Health Minister Jeremy Hunt trying to push through a new contract for junior doctors, involving changes to the pay scheme, hours worked, etc.

The gist of it is trying to get Dr's to do a 7 day week (paying them an overall higher base rate of pay, but losing some of the weekend rates [maybe late nights aswell], the other point of contention is that we don't really have enough doctors to cover a 7 day week, so these changes would stretch those we do have thinner.

Maybe a little off with my summary, somebody else maybe able to correct me.

**Ketara**

djones520 wrote:
Well, that whole strike thing that happened in the NHS recently? That didn't exactly get good press over here.

It was the first strike in the entire history of the NHS, over very good reasons, and the doctors ensured care was still available for those who really needed it.

It's not like it happens every other year and the system stops working, you know?

Automatically Appended Next Post:

Mozzyfuzzy wrote:
That was the Health Minister Jeremy Hunt trying to push through a new contract for junior doctors, involving changes to the pay scheme, hours worked, etc.

The gist of it is trying to get Dr's to do a 7 day week (paying them an overall higher base rate of pay, but losing some of the weekend rates [maybe late nights aswell], the other point of contention is that we don't really have enough doctors to cover a 7 day week, so these changes would stretch those we do have thinner.

Maybe a little off with my summary, somebody else maybe able to correct me.

The idea was that the amount of money paid for emergency cover would be raised, but what counted as emergency cover would be moved from 5pm onwards to 9pm onwards. The result being less money effectively.

The reason for this was because the Tories wanted longer doctor open hours without hiring any extra staff. This meant that the NHS would have to have less doctors on at any point in order to timetable a longer working day, but of course, this would have taken more of them into the 'emergency cover' earning bracket, which would have cost more money.

So the Government had politically motivated plans (no study has shown longer open hours results in lower patient mortality or higher efficiency), and wanted to force doctors to work later and longer hours for less pay then they'd get under the current system. Understandably, the medical professionals are not too thrilled about the Government magnanimously giving away their evenings and earnings for political objectives.

But none of that is a problem with the NHS, rather the bullheadedness of the Government.

**Do_I_Not_Like_That**

djones520 wrote:
Well, that whole strike thing that happened in the NHS recently? That didn't exactly get good press over here.

Ketara and mozzyfuzzy have explained it well, but there was also the government's refusal to listen to common sense.

The government wanted weekend care to be as good as weekday care, no problem with that, but the doctors, recognizing it was a major change, wanted to trial it out for a few months in a few regions, which again, was pretty reasonable IMO.

Unfortunately, the government then proceeded to stick its fingers in its ears and starting singing la la la la

**skyth**

Do_I_Not_Like_That wrote:
LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

The problem with having the states manage it is that certain stated would intentionally screw over their citizens if this would happen.

**Do_I_Not_Like_That**

whembly wrote:
Do_I_Not_Like_That wrote:
LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

Ideally... yes. The Federal government becomes empowered to raise taxes, then 'block grant' the money to the states 'run/administer' the services.

What gets sticky, is determining what will be covered as necessity and what is elective. Who determines that?

Best way would be to let the state decide, but knowing some folks, they'll want the feds to mandate 'you must include these things in order to recieve these grants!'

The fact that you have people determining it at federal level by voting for congressmen/women and senators, and the fact that you have another layer of oversight at state level, is way better IMO, than cowboy companies laying down the law and making the rules up as they go along...

As I said before, you'd be hard pressed to find anybody in the UK who thinks the NHS is perfect, it's not, but the USA has the money, has the skills, has the ability to provide a better healthcare system, so why not?

That's a rhetorical questions, becuase I know what the answer is: vested interests, campaign donations, and people happy to keep the status quo as it makes them rich, and if their fellow citizens should suffer, well, I doubt if they give a damn...

Automatically Appended Next Post:

skyth wrote:
Do_I_Not_Like_That wrote:
LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

The problem with having the states manage it is that certain stated would intentionally screw over their citizens if this would happen.

Never underestimate the average voter...

**skyth**

Considering the states that refused the medicaide expansion and kept voting red...yes, I feel pretty confidant at underestimating them.

Trying to put single payer in will start all the same lies about huge wait times for emergencies and death panels...and certain states would make sure that these become true just to spite the poor.

**whembly**

skyth wrote:
Do_I_Not_Like_That wrote:
LordofHats wrote:
Functionally if the government is the primary provider of medical care, then medical care becomes a political issue that can't be ignored unless the electorate chooses to ignore it*. In the US at least, that probably wouldn't be the case. Recipients of government medical aid are some of the most active voters in the country.

*Note I say it can't be ignored. That doesn't mean that it can't be made worse, as its entirely possible for politicians to shovel do nothing policies and pretend they're keeping everything working right.

As you would expect, healthcare is a major political issue in the UK.

Even though it's a national health service, there is no 'British' health service, because each of the individual 'states' in the UK: Scotland, England, Wales, Northern Ireland, run their own individual health services, to better tailor it to local needs, whilst still remaining under the national umbrella.

Couldn't the USA do something similar? Individual states tailoring things to local needs, because I recognize that tiny Rhode Island is going to be way different from Texas or California, but still sitting under the federal umbrella?

The problem with having the states manage it is that certain stated would intentionally screw over their citizens if this would happen.

What happens with the Federal Government screws up everyone? Then what?

At least each of the state has a chance to get it right...

**Do_I_Not_Like_That**

skyth wrote:
Considering the states that refused the medicaide expansion and kept voting red...yes, I feel pretty confidant at underestimating them.

Trying to put single payer in will start all the same lies about huge wait times for emergencies and death panels...and certain states would make sure that these become true just to spite the poor.

I can categorically assure you there are no death panels in the UK, and I remember a few years back, the insulting Fox News stories that said they were, and I remember nearly putting my foot through my TV screen

Yeah, I get what you're saying, and it would be a shame if poor people in red states bought into this propaganda, because there the people who would benefit the most, but ultimately are convinced to shoot themselves in the foot by hucksters and conmen who only care for their own pockets...

**whembly**

skyth wrote:
Considering the states that refused the medicaide expansion and kept voting red...yes, I feel pretty confidant at underestimating them.

Dude... the states who hasn't expanded are geniuses right now.

The who has expanded are going to have to raise taxes a feth ton or reduce services for everyone.

Trying to put single payer in will start all the same lies about huge wait times for emergencies and death panels...and certain states would make sure that these become true just to spite the poor.

"spite the poor"??

You have a very flawed view of some group/states who are different that you...

Automatically Appended Next Post:

Do_I_Not_Like_That wrote:
skyth wrote:
Considering the states that refused the medicaide expansion and kept voting red...yes, I feel pretty confidant at underestimating them.

Trying to put single payer in will start all the same lies about huge wait times for emergencies and death panels...and certain states would make sure that these become true just to spite the poor.

I can categorically assure you there are no death panels in the UK, and I remember a few years back, the insulting Fox News stories that said they were, and I remember nearly putting my foot through my TV screen

Yeah, I get what you're saying, and it would be a shame if poor people in red states bought into this propaganda, because there the people who would benefit the most, but ultimately are convinced to shoot themselves in the foot by hucksters and conmen who only care for their own pockets...

Death Panels are nothing more than a hyperbolic name for some government mechanisms that determines what services are rendered and 'when'.

Rationing finite services was unfairly being conflated to 'Death Panels'. It's a scaremongering tactic... yes, but when you get down to it, it's not false.

**Prestor Jon**

Peregrine wrote:
tneva82 wrote:
Fill up own pockets? Charge up more or do less while charging same. No competition so no need to worry about customers going elsewhere.

But if the government has a monopoly on health care then there is no incentive to profit. Nobody running the system gets any personal benefit from it, any "profits" the system makes would just disappear into the government's general budget. And there certainly won't be any bonus checks for employees who manage to increase "profits". In fact, you might get fired for finding a way to increase "profits" without immediately passing the savings on to the customers.

All monopolies are bad, period. Arguing that one entity holding a monopoly is better than another entity holding a monopoly is like arguing that Person A punching you in the stomach is better than Person B punching you in the face, when nobody wants to get punched at all.

Government has zero incentive to do perform at its best and healthcare is no different in that regard. Nationalized healthcare would be politicized and subject to partisanship when it came to funding and policies, the actual workers would have to accept whatever wages and conditions the govt offered or not work and they wouldn't have any incentive to do anything beyond the minimum required. There are plenty of municipal and state depts. that I have to work with for my job that literally tell you that they don't process any new work after 4pm Mon-Fri even though they're open until 5 and on Fridays they usually stop processing anything earlier than that. Govt run healthcare would be a monopoly saddled with massive bureaucracy, little accountability and no incentive to maximize performance.

The only way you incentivize optimal service and budgeting is through competition because competition allows consumers to avoid bad businesses and let them go out of business if they don't improve. Monopolies, both private and public, remove competition and therefore remove incentives for peak performance.

**Do_I_Not_Like_That**

The only way you incentivize optimal service and budgeting is through competition because competition allows consumers to avoid bad businesses and let them go out of business if they don't improve. Monopolies, both private and public, remove competition and therefore remove incentives for peak performance.

Slightly OT, but here in the UK, we were sold the line in the 1990s that privitizing our railway system would provide better services, better competition etc etc

Result?

Fething disaster!!!

Predictably, the rich made their money out of it, everybody else got screwed by bad service, and the taxpayer had to bail out these companies when it went wrong...

Don't believe the hype about competition and the free market knows best...

**gunslingerpro**

Do_I_Not_Like_That wrote:
The only way you incentivize optimal service and budgeting is through competition because competition allows consumers to avoid bad businesses and let them go out of business if they don't improve. Monopolies, both private and public, remove competition and therefore remove incentives for peak performance.

Slightly OT, but here in the UK, we were sold the line in the 1990s that privitizing our railway system would provide better services, better competition etc etc

Result?

Fething disaster!!!

Predictably, the rich made their money out of it, everybody else got screwed by bad service, and the taxpayer had to bail out these companies when it went wrong...

Don't believe the hype about competition and the free market knows best...

After living with the MBTA this past winter (look up that fiasco, should you want to enjoy some suffering), I'm convinced that nobody is qualified to run public transit systems.

**Do_I_Not_Like_That**

We've all seen those league tables that have the USA as the number 1 country for healthcare spending in the world, but number 23 for quality of healthcare per 100,000 people, or something like that...

Something has to change IMO...

**skyth**

Prestor Jon wrote:
Peregrine wrote:
tneva82 wrote:
Fill up own pockets? Charge up more or do less while charging same. No competition so no need to worry about customers going elsewhere.

But if the government has a monopoly on health care then there is no incentive to profit. Nobody running the system gets any personal benefit from it, any "profits" the system makes would just disappear into the government's general budget. And there certainly won't be any bonus checks for employees who manage to increase "profits". In fact, you might get fired for finding a way to increase "profits" without immediately passing the savings on to the customers.

All monopolies are bad, period. Arguing that one entity holding a monopoly is better than another entity holding a monopoly is like arguing that Person A punching you in the stomach is better than Person B punching you in the face, when nobody wants to get punched at all.

Government has zero incentive to do perform at its best and healthcare is no different in that regard. Nationalized healthcare would be politicized and subject to partisanship when it came to funding and policies, the actual workers would have to accept whatever wages and conditions the govt offered or not work and they wouldn't have any incentive to do anything beyond the minimum required. There are plenty of municipal and state depts. that I have to work with for my job that literally tell you that they don't process any new work after 4pm Mon-Fri even though they're open until 5 and on Fridays they usually stop processing anything earlier than that. Govt run healthcare would be a monopoly saddled with massive bureaucracy, little accountability and no incentive to maximize performance.

The only way you incentivize optimal service and budgeting is through competition because competition allows consumers to avoid bad businesses and let them go out of business if they don't improve. Monopolies, both private and public, remove competition and therefore remove incentives for peak performance.

Some things should never be privatized as 'optimal service' leaves out the human factor. I'm continuously reminded of the 'let them die' chants from the Republican debates 4 years ago...or the more recent Republican lawmaker telling a mother that is too poor to afford her son's diabetes treatment to just earn more money to pay for it...