A core error in government health care proposals
In an earlier post, I discussed Lee State Bureau reporter Mike Dennison’s promotion of a single-payer health care system. In the following paragraph of his latest article, Dennison reveals the core of his misunderstanding:
“I’m not one who thinks ‘government’ is an inherently bad word, since we live in a democracy. If you appoint competent, dedicated people to run a government program, it should work – and the same goes for private business. If you have a government program and you appoint political hacks and cronies to run it, then it may turn out poorly.”
One obvious weakness in this statement is that, given the way things usually operate, we are probably as likely to get “hacks and cronies” as good people. And even if that happens only occasionally, in government hacks and cronies can create, in a very short time, damage it takes good people decades to undo.
But that is not the most important error. The most important error is this: Assuming that the long-term success of a government program rests exclusively (or even primarily) on who we put in charge of it.
The Founding Fathers knew that, in the long run, the structures and incentives of an institution are more important than who operates it. That’s why they wrote a Constitution with checks and balances and many other restrictions rather than just relying on what was in those days called “republican virtue.”
If the great success of the American experiment were not sufficient proof, a half-century of rigorous work by the “Public Choice” school of economists certainly provides it. Again and again, they have shown how incentives work in government – and have found, at least in the medium-to-long run, that a given set of incentives tend to produce the same results, no matter who the actors are. (Public choice economics also has produced several Nobel prizes. Curious readers can begin with one of its journals.)
The reason the private sector is generally more efficient and responsive than government is not that people in business are personally more virtuous than those in government. It is because in the private sector the incentives to be efficient and responsive are far stronger, the freedom to respond to those incentives is greater, and the incentives to slack off are weaker, than they are in government. The reason small business tends to be more efficient and responsive than big business is, again, that the incentives to be so are stronger and the freedom to respond is greater.
As my comment about the Founders illustrates, this lesson is neither new – nor particularly controversial. But as the Dennison comment illustrates, supporters of socialized programs have never learned it. Our civic duty as Americans is now to ensure that good people like Mike Dennison never have to learn it at the expense of their own health, or at the expense of the health of others.
Us per usual, you’re flying in the face of evidence. When evidence trumps theory, you fall back on theory.
Since you’re using health care as the place where there is a “core error”, you might take some time to travel around the world a bit. Carol at Missouapolis has a great piece with about 45 minutes worth of reading about the French health care system. It’s far better than ours, and run by bureaucrats. Ours is so fraught with profit-driven entrepreneurs who must, because of the nature of the system (a core fault), deny care to sick people, that we have 47 million uninsured, 25 million underinsured, 500,000 bankruptcies this year due to medical bills.
That cannot change. It’s the nature of the system. For so long as profit margins depend on avoiding the sick, the private model for health care will fail. It’s a cor error. It’s the nature of the beast.
You’re wrong here, supremely wrong.
One little item that most “universal health care” advocates who point to other countries’ systems as being so much better than ours fail to point out is that they do not have to cover NON-citizens!!!! Even legal immigrants cannot participate in most of these plans. Foreign countries are not as inclusive, by nature, as America is, and they don’t consider it a problem that they exclude huge segments of the population in their definition of “universal”.
The US healthcare costs would be significantly lower if we could simply mandate that only citizens could be covered. Of course, the libs would go nucking futs. Unless and until the facts of the European plans are honestly and fairly compared to the proposals for this country, we cannot make a wise choice.
So you’re saying that if we deny care to illegals, our system will be fixed?
No… Mark T. I think Auntie is, in a nice way, saying you don’t know what the hell you’re talking about.
The core of the problem is… I (and probably others) don’t believe any of your numbers. Nothing. If we can’t get beyond that, what’s the point of discussing the issue?
Well, you could do some research. But that’s asking a but too much, I suppose. I should leave you to your cocoon.
Say Rob, since you are a government employee, and tenured to boot, aren’t you, by your own definition, more likely to be a hack or crony than your private sector counterparts, say at Rocky Mountain College?
Autie Lib, just to add to your point. Until the EU takes over our role as global cop you cannot honestly compare to their plans. Easy to shift public money to social welfare programs when others do all your heavy lifting.
LT – will you get something through your head? They are spending half – half! – of what we spend on health care. Half. They take care of their entire population. We leave millions out in the cold. Your statement above is besides the point entirely.
For a comparison of the French and US models, see these comments by a French expert: http://www.kcpw.org/article/4216
The French system is about $14B in the hole and sinking fast. Is this what we want to copy?
As to Mark T’s claim at Missoulapois that there are 47 million uninsured Americans there is this: http://www.freemarketproject.org/articles/2007/20070718153509.aspx
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However, the Census Bureau report “Income, Poverty, and Health Insurance Coverage in the United States: 2005,” puts the initial number of uninsured people living in the country at 46.577 million.
A closer look at that report reveals the Census data include 9.487 million people who are “not a citizen.” Subtracting the 10 million non-Americans, the number of uninsured Americans falls to roughly 37 million…
…But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326…
Subtracting non-citizens and those who can afford their own insurance but choose not to purchase it, about 20 million people are left – less than 7 percent of the population.
“Many Americans are uninsured by choice,” wrote Dr. David Gratzer in his book “The Cure: How Capitalism Can Save American Health Care.” Gratzer cited a study of the “nonpoor uninsured” from the California Healthcare Foundation.
“Why the lack of insurance [among people who own homes and computers]? One clue is that 60 percent reported being in excellent health or very good health,” explained Gratzer.
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” We leave millions out in the cold.” We?
How about federally mandated life? It will be illegal to get sick and die.
No – the courts are making it illegal to get sick and live. Montana moves down the path to legal doctor assisted suicide.
Craig – I’ve dealt with you over at Carol’s place. No more.
Mark, your prevarications continue, but at least you are consistent in avoiding fessing up for your errors.
Mark T,
You would strengthen your argument if you would admit that many of those 47 million uninsured: 1. are uninsured because they can afford it but choose to spend their money on something else 2. are healthy and just do not see the need 3. include many people who make bad choices which leads to poor health 4. include those who can’t afford insurance because they do not have a job as they refuse to work or get an education.
If Liberals would make that admission, I think you would find many more Americans willing to work on improving care for those truly in need and deserving of a helping hand.
There will always be folks left out of the equation in some manner. If we adopt a government run Universal care model, there will be more delays in care and rationing of care for the 85% of people who previously had insurance and were relatively happy.
Mark, are you really willing to sacrifice the health of YOUR family in order to give that 15% uninsured, guaranteed healthcare? No matter how you slice this pie, there is only one pie to slice. If a large group of people obtains more access, you will get less. Many liberals love to come up with these compassionate plans for humanity (otherwise known as all those little people who live in flyover country), but they usually have no intention in paying for these programs or even participating unless it helps them as individuals.
Examples include: the environmental hypocrites who preach clean energy while flying private jets, the SUV liberals who drive large gas guzzlers with Greenpeace stickers on the bumper, the liberal elite (including our President-elect) who send their kids to private school while they refuse to support voucher programs that would allow “Joe the average citizen clinging to his guns and religion” a chance to send his kid outside the miserable ‘public’ system of education.
Mark T is a Kool Aidaholic, he can’t help it. It’s very hard to get off the junk once you turn your life over to it.
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