Health Care and the Role of Government

Dave Winer makes a good point in a post on the identity of government

The cure, imho, is to create new business entities that serve the users first. Sure the shareholders make money, when you take a risk and produce a product or service that people want, that’s great and there must be rewards or people won’t risk. I’m a capitalist. But the things these companies are doing now is not capitalism. They know we don’t have time to understand all the ways they can screw each of us individually. If we did, there would be no time for living. So we should hire people to study what they’re doing and route around it. Either make it illegal, or start a co-op to offer the same service or product without the gotchas.

That’s the reasoning behind the health insurance “public option,” which is a damned good idea. We’ve tried it the way the insurance industry wants to do it, and the result is a lot of needless death, sickness, and wasted money. So, they can keep doing what they’re doing, but we’re going to pool our resources and self-insure. We could either form a new entity to do it, or we could use the one we already went to the trouble to create.

I’ve been complaining in other posts about how entities do business in the local village, what services are offered and how this is done or not done to service of a core need. What is capitalism? Is it making a living and providing service (insurance companies don’t wield scalpels) or is the business plan about money first? The role of government, in a definitional sense, also comes back to every congressperson’s role, as well.

5 thoughts on “Health Care and the Role of Government

  1. gibb

    You love teaching–which is a paid service, either by the consumer or by the provider–and you might do it as a hobby if it were a volunteer thing, but would you be willing to be a teacher full time if you weren’t being paid? Should any company, service be non profit? Should barbers cut hair for free or just to cover expense or what YOU might think they SHOULD make as a profit?

    Unless we lived in a society where everyone has a job to do and everyone’s job is valued equally–the garbage collector being just as important as the teacher–then profit is a motive to provide a service or product.

  2. Steve Post author

    One alteration: “then profit is a motive to provide an ‘excellent’ service or ‘excellent’ product” not a crappy one. The point is that when profit is gained for poor, little, or no service (such as credit default swaps, which produce nothing of usable value), someone needs to step up and fill in the hole.

    No one around here is naive enough to suggest no-profit relationships promote innovation as even barter is an exchange of services, if bot people agree to the value of the exchange–I’ll give you two rabbits for a shovel is not a good swap. The reason that I can be paid is because typically for every dollar that goes into the college money is made for the community, and someone will earn more and contribute because of their time at the college: its a well documented synergy.

    You uppercase YOU and SHOULD above, I assume, to suggest that I would want to control profit margins based on personal whim. Why? Is there an ethical scale to margins: say, hypothetically, a company is provided 100 or so billion of your money to stay afloat, on the promise of more vapor products and, when you call, plenty of run around.

  3. gibb

    On your first point, the consumer should be the one making the decision on whether they are getting good or bad product/service–not the government (unless something is possibly fraudulent or dangerous, which is what the Consumer Protection Agency is about). It’s also a matter of pov, and it’s obvious that one person can love something and another absolutely hate it so I’d rather the consumer have the majority say rather than a government agency which could easily be bribed by lobbyists.

    Two rabbits for a shovel can be an absolutely wonderful swap if each fulfills the other’s need or want. I only use teaching as an example because it is more relevant to your approach and it is a service rather than a physical product.

    My uppercase was not directed to you personally, but to the “you” in general who want to standardize according to “their” own wishes which defeats the concept of free enterprise. In other words, I believe someone has the right to produce a shitty (though not dangerous) product)and it’s up to individual intelligence not to support it by buying it.

    I’m not saying that corporations, companies, individuals do the right thing but government agencies seem to me to be run even worse.

  4. Steve Post author

    “I’m not saying that corporations, companies, individuals do the right thing but government agencies seem to me to be run even worse.”

    You mean like the big banks and hospital emergency rooms (sorry, I don’t mean to be sarcastic, but I don’t see validity: license renewal, AAA to the rescue).

    We don’t need to parse any of this to its skeletal structure, I don’t think, but we do need to understand each other. Hypothetically, you are correct to assert buyer choice, but realistically, choice is an ethic corporations fight to squash. People don’t need cable, but without the industry, all areas of the economy would suffer tremendously, but there is no real choice in cable, insurance companies or utilities, hence no real capitalism.

    I would suggest that you are an idealist when it comes to business issues.

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