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I find it ironic that you stated the answer to your own question and didn't notice. That is, how notoriously terrible the government is at organization is a ma

by btilly 8y ago

I find it ironic that you stated the answer to your own question and didn't notice. That is, how notoriously terrible the government is at organization is a major reason for why people are against universal healthcare. Whether their concerns are overblown or not I leave to opinion. But that is a major fear for many.

Someone1234 8y ago
Medicare seems to work just fine.
acdha 8y ago
> how notoriously terrible the government is at organization is a major reason A major propaganda point, not a reason based on data. It’s really hard to find a first-world country which has a medical system which doesn’t compare favorably with American insurance companies on either cost or quality — the baked-in conflicts of interest are too powerful.
- mattkrause 8y ago
  Insurance companies are also not exactly....paragons of good customer service themselves. I was camping with a friend when he managed to slice off the tip of his finger. The insurance company fought him tooth and..err...nail to avoid paying out for not having the ER visit “pre-approved”
  - acdha 8y ago
    That was my point: I’ve known a fair number of people from other countries and I’ve never heard any reaction other than stunned disbelief when they experienced the American private insurance system — up to and including giving up jobs here just to avoid the stress of not knowing whether you really will get treated or not.
mikeash 8y ago
I can sort of understand someone thinking that the government is bad at organizing large projects. What I don’t get is how so many people think that while simultaneously thinking that the government is the right tool for carrying out gigantic projects like completely reimagining the government of a foreign country that doesn’t want it.
- btilly 8y ago
  shrug People are good at being inconsistent. News at 11.
  - mikeash 8y ago
    This particular set of contradictory views is very consistently held among a large group of people, though.
rootusrootus 8y ago
I've always found it slightly amusing that the mostly unchallenged conventional wisdom is that private enterprise is more efficient and better organized that the government. Sometimes I wonder if the people who really believe that have ever worked for a large corporation. I also think people forget that, in any case, the gov't is not a private enterprise and efficiency is actually not their first mandate, it's effectiveness.
- btilly 8y ago
  You might find a more sophisticated version of that conventional wisdom to be less amusing and more worthy of food for thought. It comes from Ronald Coase's theory about the natural size of companies. Companies exist at the tradeoff where the costs of transactions between multiple companies equal the internal inefficiency of a large organization. The larger the organization, the more it tends towards inefficiency. Anything that decreases transaction costs, decreases the size of organizations. And vice versa. From that you expect large organizations of all kinds to be inefficient. Which fits your observation. Now note that government organizations tend to be are large organizations with a tendency towards complexity and no incentives for efficiency. How do you predict that will work out? Again, whether or not this is a compelling argument is a matter of opinion. But if you want to understand the views of those who don't like government healthcare, this is a key point to keep in mind.
fzeroracer 8y ago
Are corporations really that much better though when it comes to organization? We've just offloaded all of the terrible organization to large corporations like ISPs or health insurers, which don't actually have the consumers best interests in mind. I've worked for a government contractor in the past and I can tell you that private companies will do everything they can to drag their feet or siphon money while creating bureaucracy on the level of any government agency.

by btilly 8y ago

Someone1234 8y ago

Medicare seems to work just fine.

acdha 8y ago

> how notoriously terrible the government is at organization is a major reason A major propaganda point, not a reason based on data. It’s really hard to find a first-world country which has a medical system which doesn’t compare favorably with American insurance companies on either cost or quality — the baked-in conflicts of interest are too powerful.

mattkrause 8y ago
Insurance companies are also not exactly....paragons of good customer service themselves. I was camping with a friend when he managed to slice off the tip of his finger. The insurance company fought him tooth and..err...nail to avoid paying out for not having the ER visit “pre-approved”
- acdha 8y ago
  That was my point: I’ve known a fair number of people from other countries and I’ve never heard any reaction other than stunned disbelief when they experienced the American private insurance system — up to and including giving up jobs here just to avoid the stress of not knowing whether you really will get treated or not.

mikeash 8y ago

I can sort of understand someone thinking that the government is bad at organizing large projects. What I don’t get is how so many people think that while simultaneously thinking that the government is the right tool for carrying out gigantic projects like completely reimagining the government of a foreign country that doesn’t want it.

btilly 8y ago
shrug People are good at being inconsistent. News at 11.
- mikeash 8y ago
  This particular set of contradictory views is very consistently held among a large group of people, though.

rootusrootus 8y ago

I've always found it slightly amusing that the mostly unchallenged conventional wisdom is that private enterprise is more efficient and better organized that the government. Sometimes I wonder if the people who really believe that have ever worked for a large corporation. I also think people forget that, in any case, the gov't is not a private enterprise and efficiency is actually not their first mandate, it's effectiveness.

btilly 8y ago
You might find a more sophisticated version of that conventional wisdom to be less amusing and more worthy of food for thought. It comes from Ronald Coase's theory about the natural size of companies. Companies exist at the tradeoff where the costs of transactions between multiple companies equal the internal inefficiency of a large organization. The larger the organization, the more it tends towards inefficiency. Anything that decreases transaction costs, decreases the size of organizations. And vice versa. From that you expect large organizations of all kinds to be inefficient. Which fits your observation. Now note that government organizations tend to be are large organizations with a tendency towards complexity and no incentives for efficiency. How do you predict that will work out? Again, whether or not this is a compelling argument is a matter of opinion. But if you want to understand the views of those who don't like government healthcare, this is a key point to keep in mind.

fzeroracer 8y ago

Are corporations really that much better though when it comes to organization? We've just offloaded all of the terrible organization to large corporations like ISPs or health insurers, which don't actually have the consumers best interests in mind. I've worked for a government contractor in the past and I can tell you that private companies will do everything they can to drag their feet or siphon money while creating bureaucracy on the level of any government agency.