Canon Chapter 14
Respond to question # 2, using your insights from Wilson, Hacker, and your main text.
posted by Mr. K @ 9:16 AM
12 comments
Walker Political Science Discussion
Welcome to the Political Science Discussion Page for the Walker School. Although technically this is a public blog, we would appreciate it if you not post comments unless you are a member of this class.
12 Comments:
The criticisms listed are certainly valid, but to what extent? I have a hard time accepting that the potential problems with government subsidized insurance are so widespread or extreme as to render the programs 'not worth it'. Although I will say that I think the worry about providers shifting more costs to privately insured or uninsured people seems more significant. I mean, this is an area of clear crossover between the domains of private and public programs. I'm relatively uninformed about the nuances of government programs, so someone please enlighten me as to the reason Medicare has been barred from negotiating prices on prescription drugs and Medicaid has not. It seems like there should be an ideal balance to shoot for where Medicaid pays relatively low prices to providers and costs to privately insured or uninsured people don't go up. Obviously 'ideal' isn't very practical, but I'm thinking of perhaps an optimal range of price limits? I'm afraid I'm not too certain.
I love when Hacker concludes that "ultimately, social insurance is good for the efficiency of society as a whole, not just because it provides much-needed protections at a reasonable cost, but also because it allows people to deal with what FDR once called the 'hazards or vicissitudes' of modern capitalism without draconian restraints on the free play of the competitive market."
I'd just like to comment that Wilson makes a very strong central point that government agencies, unlike private organizations, are stringently controlled by a multitude of outside factors which can prevent seemingly sensible solutions from coming to fruition. A shining example of hyperpluralism, yes? Where this ties in with the insurance issue is that any possible solution for Medicaid's effect on market prices becomes quite convoluted and unlikely to germinate.
I know that officially we are to address question #2, but I found #3 fascinating as well. We talked about it in class, credit claiming and constituent service. Isn't that a depressing thought, that the people who have the most control over beuraucratic agencies might possibly be motivated to keep those agencies from improving? I'm not saying I believe that statement or disagree with it, I just think it's interesting to consider.
Okay first off Audrey to address your questions concerning medication bargaining within Medicaid versus Medicare it all really boils down to the drug and pharmaseutical companies. I really hate doing this since it's kind of off topic but the main problem with health care and pharmaseuticals in general is that you're essentially putting a price on one's quality and quantity of life. If you haven't seen it I seriously suggest watching The Constant Gardener. No matter which way you cut it these companies are making a buck off of selling things that you hope you'll never need but ultimately will whether you like it or not unless you're some sort of Biological machine immune to all physical harm (of course even then you're certainly going to need counseling for such a weighted blessing/curse). In any case these companies are notorious for their less than moral practices but hey, we live in a capitalist society where socialism is treated like the plague (isn't that right Jarrod) so its perfectly okay to be exploitative of those less fortunate once in awhile. I mean they TOTALLY chose to come down with a life threatening illness that requires medication they can barely afford with insurance. That is of course provided that their insurance company doesn't drop their policy leaving them in the infamous "lazy lower class that they chose to be in because they didn't want to work and would much rather live like leeches off of those more fortunate than they are". I'm sorry folks but I'm getting more than a little tired of how close minded the mere concept of Socialism is being approached with in our class. Sit on your gold piles as long as you want Nobility of America, you've earned the right to stare down at those struggling to make ends meet. I applaud you for your unwavering fortitude in the situation. Don't get me wrong all capitalism is not bad. I simply question the amount of regulation put on companies making a business out of manipulating the general wellfare of the people. I'm being realistic here and saying there is no utopia and even attempting to create such would only have catastrophic effects on society and free will. All I'm asking is that everyone plays fair and the big guys aren't squishing the little guys with the heel of their boot under the banner of "it's just capitalism". Wrong, Capitalism is supposed to be the competition of companies for the benifit of the economy and consumer. No where in the basic outline of Capitalism is there any clause where exploitation is fair game. Keep what you earn I can understand but once that bleeds into inhumane greed and corruption I put my foot solidly down. I'm well aware that a good 1/2 of the class will have fun tearing this blog apart (that's accounting for those who don't read the other blogs and those who would rather not be as biting as I have been which I appreciate). No more will I be the kicked dog (Amstuders yeah! But this has been fun! Nothing gets bad chi out better than an angry blog vent. Thanks Mr. K!
Before I get into the actual question, I would like to point something out. We just read about how the government is inefficient, regardless of whom or what you want to blame. My question is: Why would you want the government in charge of your healthcare like certain politians are proposing? It seems like now we have the efficient McDonald’s version of healthcare (capitalism), and some people want to move to the DMV version (socialism). It’s pretty clear which one works better. Moving on.
It makes sense in one regard to not let government organizations keep their profits. Unlike McDonald’s, much completion for say…firemen is not realistic. So letting the fire fighters keep their profits could lead to dangerous consequences for the public. But the inefficiency of many government organizations needs to be addressed. I believe that except in matters of national defense, many organizations and programs should be either privatized or scrapped completely (Social Security and the IRS come to mind).
Disadvantages of government programs are numerous. I remember our textbook said how hard it can be to fire incompetent people from the bureaucracy. So we end up paying people to stay who really do not do anything efficiently simply because of bureaucratic rules. In addition, in AP Micro today we talked about how when firms get too big, they become very inefficient because of the need to monitor everyone. Firms have to hire people to watch over the workers, and then hire people to watch over the first watcher-overs, and so on. It ends up being cheaper to simply have smaller companies. The government ends up with several of these too big organizations. I think in markets where competition is viable, in almost every case it is better to go with the free market version rather than the government run system.
The potential disadvantages of publically provided insurance are the speed of providing the care, the lack of production value because of lack of incentives, lack of qualified workers, or covering areas they are not qualified to cover, cannot care for their members because they do not keep profit, administrators have hardly any say so, and must serve goals of others choosing. The criticism of shifting cost could be valid but eliminated by providing universal health care. If the insurance company is overseen by administration they cannot short the people they are providing for.
Both Hacker and Wilson make very convincing arguments about the efficiancy (in the economic sense as well as the words regular connotation) and how these agencies often foster seemingly bogus desisions. Now, I am extremely tired, so these answers will be maybe a little too breif, in fact, you might say that they won't "cut it" (Sweeney Todd reference, anybody?) Ahhhh, man I'm an idiot. Ok, back to my favorite light reading: Fault Lines. I think that this question is interesting especially as we researched the candidates viewpoints on the economy and how nationalizing healthcare is a huge issue as election day approches(and by that I mean tommorrow). I personally don't think that subsidizing these programs, we are huritng the free market principles behing America's foundation to a certain extent, by having people rely too much on the government to pick up their respective slack. I feel that we should have bureaucracies and that they certainly serve important purposes within USA, but I think they need to have more regulations, kinda like the McDinalds example. This would help the bureacracies become more privatized and foster more competition amognst businesses. If these agencies up the quality a little bit, then there will be less motivation for everyone to seek private healthcare and put these big conglomorates in control. The medical insurance companies will have to compete with the government, instead of using it as a proverbial backup.
I agree kinda with ian on his tangent about healthcare, except that the American health care system is not really health care at all-- its sick care, because that's the only time you need it. We should consider switching to a more natural form of care. Think about it; we love organic and going green stuff, right? It makes sense to try it out with all aspects of weel-being, not just eating free range eggs. I tried Chiropractic, and its the way to go--not to mention it will cut costs for all this symptom-eliminating medicine that really doesnt heal the body at all, thus making the issue of naitonal healthcare much less complex with out all the gingerbread of pills and hundreds of types of doctors. Wow. I thought that my points would never find a way beack on topic, well...sort of. And i wont even bother to try and tear your blog apart Ian because you are so dense I cant even type right now (does that make sense. hjeuifjbf...SEE GET OUT OF MY HEAD IAN. told you I was tired
Just because people have insurance doesn't mean they will use it. If i build my house in a flood plain, and then it gets flooded, the house will get rebuilt on insurance money, but it will take a long time becuase i feel that government insurance would be low to respond. i also think that government claims adjusters would be much much stricter than private ones, beucase of the amount of claims and the over all cost. Also, people all ready save some retirement money through social security, and then through private banks. so wh ywould they stop saving at abnks, especailly if banks give better rates and higher returns. If all the rpivate insurance holders shift to government healthcare, then there would be no one to shift prices onto. Plus laws could be passed to stop shifts from price gauging people, since i'm sure there would have to be a slight shift in any case
I think it is quite clear that these criticisms are valid. The vast size of the United States lends itself to inefficiency in a bureaucratic system which is already by its very nature inefficient. I dislike the author’s use of the word “efficient” to describe government insurance programs. He explains that they are “efficient” because there is not a great deal of administrative costs compared to private sector companies and that everyone is forced to participate which makes risk less. What this term does not account for is the inefficiency and lack of service that citizens encounter in such programs. I completely resent a socialized form of healthcare because under that system the competition that exists with capitalism vanishes. I believe that when competition disappears there is no longer progress, and without progress there is no scientific discovery. Other disadvantageous include lack of quality in services and lack of urgency and individual attention. Just because government based insurance programs are more efficient monetarily does not mean in practice they are more efficient. I believe that every individual should be responsible for his/her own health insurance and retirement, and not rely on the security associated with nationalized programs. I apologize for the bad English, but I am incredibly tired right now.
I don’t appreciate the snippiness of your blog Ian. I’m sorry you’re under the impression that we are all the product of the closed minded “Nobility of America” and that we just look down at the less fortunate struggling to make ends meet. I actually AGREE with some of your points, but your antagonism wasn’t appreciated (at least by me…) Also, I liked Ryan’s proposal of a more natural form of care. That was very interesting and I would have to agree with a lot of that.
Anyway, Wilson argues that government agencies are not as efficient as businesses because businesses have one clear goal (maximizing profit) while government agencies’ goals are often vague and difficult to meet. Private organizations have much more control over their goals and structures and have motivation to improve and become more efficient. However, in the case of insurance, Hacker’s argument shows that public agencies’ are more effective because of the “socialization of risk”. This makes sense and seems to work. It lowers cost and provides more insurance. That sounds reasonable. But, with everyone insured, who is to determine the quality of insurance? If there is no competition and no clear goal (except for providing everyone with insurance), than what determines the quality of the insurance? Or even the speed at which anything is done? Take healthcare for instance. Sure, I’m covered by the government, but what incentive does the government have in providing me (and others) the best medical care? They have millions of other people to worry about.
Ian brings up some valid points, however. Private Insurance companies are after one thing: money. There goal is not necessarily to provide the best healthcare, but to make a profit off of people (hence more expensive rates for people with health issues). While the goal of a profit leads to competition among other companies and thus better healthcare, it still does not make the system more efficient nor does it have people’s best interest at heart.
These criticisms are all valid, but neither program can be perfect and perfectly suit everybody's wants and needs. The fairest way for the government to handle healthcare is to allow citizens to purchase the one that suits their needs best. People should be around to shop around to BUSINESSES to find the healthcare that best protects them. The government should not control what kind of healthcare you have, because each person, each family has different wants and specific needs. Universal healthcare is clearly not more efficient than privately owned businesses. How can one standard program meet the desires of every unique citizen? A lot of people would take advantage of this system. It would definately be way too risky. I think that this country has run by capitalism efficiently and changing the entire system would be foolish and regressive.
The criticisms that providers will simply shift more costs onto customers who have private or no insurance are valid. I agree with Alexcia that no one program can fit someones needs. It is up to them to choose what program helps them out the most.
As for the potential disadvantages of Government insurance programs over private programs, there are several. One is that government programs by subsidizing insurance do increase risky behavior by clients. Also, even for a government program, the sheer number of people that would need to be dealt with would slow down the process of providing care (DMV analogy).
I am intrigued by the constant reference to "efficiency" and what each of you seem to mean by it. By efficiency you might mean using the least effort to attain maximum result. You could also mean expending the least money in order to obtain the least most profit. Capitalism is a wonderful system for achieving a lot of wonderful results. However, is it the only way to achieve everything? Capitalism is a reductionist system, meaning it views all interactions a reduced to simple transactions, a rationally determined tit for a rationally determined tat. Reductionism is superb for simplifying analysis, but simplifying analysis sometimes hides fuller truths.
Take your relationship with your parents as a case in point. Is there nothing in that relationship which is purely transactional. They give you something (love, shelter, food, clothing, education, transportation, entertainment, security, birthday presents, spending money) in exchange for, well, what exactly?
Are you REALLY worth what you have been given? It is possible to argue they do these things as a result of biological imperative, they are protecting their genetic future - so assuming you do not drive off the interstate into a tree at 80 mph or overdose on heroin before you can create children, the transaction is complete. Oh, and if you can visit them a few times in the nursing home, the investment pays interest.
That MIGHT be the explanation for why your parents do what they do, and if so, you could evaluate the relationship as rational and thereby an efficient use of resources.
Oh, but you might find it easy to argue, that that relationship turns out to be pretty efficient as far as your input goes. Relatively speaking you get great value for what you expend. As your parents are unlikely to produce any more offspring, you can think of it as a permanent "Going out of Business Sale."
The point here is to tweak your quaint notions of what "efficiency" actually means. Medicaid began to provide prescription medication in the 1960s when the program was first created. At that time, protection of the interests of the poor as well as the interests of the taxpayers was of greater priority than today. The Medicare drug reimbursement plan was created just a few years ago sometime after the idea came back in vogue that government programs can do a really nifty job of providing lovely financial goodies to people who are well placed in government (BTW, this idea is not new, it just waxes and wanes depending on the mood of the country, the particular administration, and the effectiveness of the particular interest group in getting its voice heard)The pharmaceutical lobby AKA "Big Pharma" was able to get the law written so that the government could not negotiate the price paid. Not very efficient for the government or the tax payer, but extremely efficient for the drug lobby.
This is my way of suggesting to you, after all this discussion about socialism and redistribution of wealth, you should realize this truth: (wait for it)
WHENEVER THE GOVERNMENT TAXES AND WHENEVER THE GOVERNMENT SPENDS, IT REDISTRIBUTES WEALTH.
The only thing that ever changes is who pays the most and who receives the most.
Liberals argue that government programs benefit the wealthy (Obama: "Billions of dollars of taxbreaks to Exxon") and conservatives argue the wealthy get the shaft and it all goes to the poor (Reagan: "The Welfare Queen who drives a Cadillac"). My advice to you is that you should realize you are being manipulated into believing only what you want to hear.
Both are right. But their truth hides the real picture. Yep, poor people get benefits paid for by those who are wealthier than they are. But what are the benefits? Medicaid (And who benefits when the government pays for medical for the poor? That would be doctors, nurses, other health care professionals of a wide range of incomes, plus pharmaceutical supply companies, and hospitals/clinics), Foodstamps (which provides added income to farmers, food distribution companies, supermarket chains, and local groceries), subsidized housing (giving aid to local governments that operate housing projects, as well as the construction industry being paid to build such projects, houses and apartment buildings, as well as the banks that lend money for those projects).
No one argues we need a robust national defense, but what are we paying for? No doubt the US has the most powerful military operation on the planet. But just how powerful must it be? We could probably get by with a very large expenditure, say triple what the second largest military spends. But the US expenditures on defense equal the combined expenditures of the the largest 20 military programs in the world, this before you calculate the spending for operational costs in Iraq. Now you can look at that statistic with a certain amount of pride or a certain amount of disapproval. Either way, is fine, but the real question is "What have we paid for with all that money?" Watch the following video:
http://solari.com/missing_money/cbs.html
Since that report aired around 2003, another couple of $trillion appears to have "disappeared."
You can bet SOMEbody is getting that money and it is probably neither Exxon nor people on welfare.
Redistribution of wealth indeed.
Efficiency for someone, but not for the taxpayer.
I entirely agree with crouch. Although these government run programs might be me more monetarily more efficent idealy, that does not mean it is true in practice. Capitalism inspires competition amongst business and thus allows for progress. Almost every psychological theory suggests that human nature is not spurred on without any incentives. With socialism, every person is expected to be handled equally, thus people have no incentives to do their job efficently or correctly. I love Jarrods example about socialism being like the DMV. Has anyone ever seen the movie Brazil? Its old but it is a perfect example of how slow and confusing large business becomes and applies directly to an overbearing government. And Ian im being realistic here when I say it doesnt matter how good the idea sounds, there will always be people who will manipulate the system and take what they can get. Greed might be a sin, but its definately not present in todays society. Look at communism in every country that adopts it. I'd love if everyone could get along and share, but it just doesnt work that way. Thats why we have a system that allows for people to have the chance to get what they want by working for it. Do you not believe hardwork is an admirable quality? Because in America those people you talk about that can't help that they've come down with some sickness could've helped the fact that they can't pay to avoid it. No one stopped them from getting an education and making something of themselves. And yes I agree soem people are born into harder circumstances, but that really does not mean that the people that earned their way in life have to pay for others misfortune. I may sound cold hearted but im just being realistic. Back to the main point though- the governemnt getting involved in my personal affairs, whether its safety or healthcare (i dont really care) is not welcome. I can take care of myself and everyone worth having around should be able to. Darwinism baby.
Post a Comment
<< Home