Talk:Health care

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I'm removing some opinionated discussion from the general page and adding it to the discussion page. I think the below is a worthy topic of discussion, but far too much just individual opinions at this point to be on the main page. Kbal11 19:50, 8 July 2006 (UTC)

• What evidence is there for the notion that the government is always less efficient than large corporations? By all accounts I've seen, Medicare is more efficient than any major health insurance provider. Competition has built-in inefficiencies that the government doesn't have: advertising, need for profit. Larger corporations also have built-in inefficiencies that mirror those of the government's: bureaucratic overhead, pensions, etc.

The reason that private enterprise is more efficient than government is that it has incentive. People work towards making profit. Shareholders make sure that the company is doing its best to make profit. Government is different. It does not need to make profit. It does not even need to break even. It will get money no matter what. No one has real responsibility. No one's fortune is invested in it. Built-in inefficiencies of competition are almost always greatly eclipsed by this. You are somewhat right about large corporations' inefficiencies, but they aren't nearly as bad as government's. They still have to make money. Medicare costs about 400 billion dollars per year. Health care insurance makes billions of dollars per year. There are many examples of government inefficiency, but a good one for this discussion is the Canadian public health care system, which costs a lot of money. People often have ridiculous waits for operations, to the point that they go to the US to get treatment. Millenniumman 02:26, 8 July 2006 (UTC)

The July 17 edition of Business Week has a very interesting article (unfortunately requiring paid subscription to view online) about the VA in the United States. They present a detailed and convincing argument that the VA system is currently the best functioning medical system in the U.S. (Note, the VA is a government institution). This was a bit of a surprise to me, both because the VA has a poor reputation (stemming from the early '90s, when it was so bad that it was almost shutdown, but instead was dramatically reformed), and because I have previously argued very much along the lines of Millenniumman. However, they do give some indications as to why. The biggest reason why economic theory has suggested (and in practice, it has usually occurred) that private enterprises will be more efficient tha public ones is that the incentives for efficiency are better. However, the VA has very deliberately set about to create the right incentives for improved performance. They have increased individual responsibility and accountability, as well having a system where they get one lump sum of money and get to keep any money saved due to efficiencies (such as preventative care). This is different from the current insurer/hospital scene in the private medical world, where often it is the insurer who reaps benefits if the hospital saves money, while the hospital is paid more based on numbers of patients and procedures. This article, among other things, has led me to believe that the devil is all in the details; private institutions may more often have the right incentives for efficiency than public ones, but it is not guaranteed, and a good public institution may well beat out the current private ones. - Kbal11 20:11, 8 July 2006 (UTC)

[edit] This article needs tabs

This article is really long, and needs to be broken up, probably using the tabbed template. Chadlupkes 16:55, 22 August 2006 (UTC)