The loudest voice, piercing through the debate over health care is unquestionably sure "privatization is always better." Because Republicans (who are in the government) will readily tell you - the government never does anything right. Which explains why the most popular people in their Grand Old Party no longer hold any personally "taxing" jobs in the government (Mitt Romney, Mike Huckabee and as of Sunday, Sarah Palin), opting (fittingly) for private political gigs.
Less government control is always good? The private sector is always first-rate? Free market capitalism is the cure-all? Even for health care?!
Let's look at this reasonably: Firefighting used to be a private for-profit industry. In the 1800's, the early days of urbanization, in cities like New York and Baltimore, there were private "clubs" or "gangs" who were in charge of putting out fires. The infamous Boss Tweed started his illustrious political career at a volunteer fire company. The way it functioned was the first club at the scene got money from the insurance company. So, they had an incentive to get there fast. They also had an incentive to sabotage competition. They also often ended up getting in fights over territory and many times buildings would burn down before the issue was resolved. They were glorified looters. It was corrupt, bloated and expensive -- but at least it wasn't the much maligned "government controlled."
Around the time of the Civil War, firefighting in big cities was reformed and taken over by the government. Currently firefighters in most major metropolises are trained by the government, employed by the government and given health care -- wait for it -- by the government.
Yet if we had to have the "conversation" about the firefighting industry today, we'd have socialism-phobic South Carolina Sen. Jim DeMint on the TV every chance he could get saying things like, "Do you want a government bureaucrat between you and the safety of your home?"
Rep. John Boehner of Ohio would hold press conferences and ask, "Do you want your firefighting to be like going to the DMV? Do you want Uncle Sam to come breaking down your door every time some Washington fat cat says there's a fire?"
There would be 30-second TV spots paid for by the powerful firefighting lobby featuring stars and stripes graphics and the national anthem playing softly in the background with a booming voice-over trumpeting, "Founding Fathers George Washington and Thomas Jefferson were volunteer firefighters. Support traditional values and oppose government waste. Tell your representative you want a bi-partisan solution to fire reform."
News programs would be interviewing sobbing people whose homes fell through the cracks and burned to the ground. "I don't want to see the government take-over firefighting, but I sure miss Momma's oil paintings."
And President Barack Obama would relay his childhood experience with a fire then point out the failure of the for-profit firefighting industrial complex that "threatens to bankrupt this country." And then those most in need of firefighting services would foam about his birth certificate and confuse Karl Marx with Charles Darwin on misspelled protest signs at events put on by covert firefighting lobbyists.
But instead, today firefighters are national heroes. They're organized, quick, competent and with few exceptions pillars of the community. Their duty is to protect people and their property and they do it. They make no profits, are part of the government and they help people 24-hours a day. They even let seniors live. No debate necessary. What started out as a shady gaming of the system where the general public's welfare was at risk is today something of national pride.
So government can do something right. It's happened.
Less government is not always good. The private sector is not always first-rate. And free market capitalism does not cure all.
Do I want my health care to be like the DMV? I've seen clinics that make the DMV look like destination spa. DMV is affordable and I can always get seen the same day (I have insurance and I can't say the same about my doctor). So yeah, DMV-esque wouldn't be too bad. What would be better is if doctors could be like firefighters.
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There are plenty example today (not 1800) of private fire protection companies doing a great job and being more efficient than their public counterparts.
Here is one study on Private vs. Public fire service: http://reason.org/news/show/122159.html
Here is another example of a successful private Fire Protection service in operation TODAY:
http://www.heartland.org/publications/budget%20tax/article/18741/Privatized_Fire_District_Keeps_Costs_Low_and_Service_High.html
Even going back to the 1800s this was not a "free market" as you claim. Its alluded to with the Boss Tweed reference, but the fact is the fire service was part of the corrupt political machine in New York. There was governmental interaction/regulation/control of the Fire Department in New York going back into the 1700s. I suggest you read up on the history of the New York Fire Department:
http://www.usgennet.org/usa/ny/state/fire/
If the problem of competing fire services was that much of an issues (houses burning down, people dying, fistfights in the streets, etc.) do you think that would be tolerated? Doesn't it seem reasonable that either A) an insurance company would contract with a particular fire protection company to service all their clients, or B) the property owner would have a contract with a particular provider.
Miles White - Abbott - $17,395.00 an hour
Fred Hassan - Schering-Plough - $15,677.00 an hour
Bill Weldon - Johnson & Johnson - $13,022.00 an hour
Bob Essner - Wyeth - $12,552.00 an hour
Ron Williams - Aetna - $12,656.00 an hour
H. Edward Hanway - CIGNA - $6,373.00 an hour
Angela Braly - WellPoint - $5,127.00 an hour
Looks like the insurance executives are getting screwed compared to the drug company executives. Poor guys!
The problem is there's really no incentive in the current model for the insurance companies to control health care costs - the more prices rise the more the insurance company can justify raising insurance premiums, while we all know they game the system to kick out the high risk people.
If I'm in a car accident, that insurance pays for what happened, even if I am so banged up I can no longer drive and stop paying premiums. As long as the policy was in effect on the day it happened, everything else that results from that accident is covered.
Health insurance, though, is obviously not that useful, or structured to protect us. It's a way to distribute the payments for the healthy. The insurance companies are effectively profiteering; they're skimming lots of money off the top while creating paperwork that has led to Duke Medical having more billing clerks than they do nurses.
So, free-market has its place, but either it's not working properly in the case of health insurance companies, or it's not the right solution. Costs have soared faster than inflation for over three decades, while nearly 1 in 6 Americans is uninsured - and that number grows by over 10,000 every day. What's the leading cause of personal bankruptcy filings? Medical costs are.
Time for a change.
Good article.
Sorry, but I think you've missed the mark here.
Oh -- and their books and records, as well as the salaries of their personnel, are PUBLIC RECORDS. They cannot operate in secrecy like private corporations.