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Services, such as healthcare, public infrastructure, public transport, energy etc should be run by the state. There is always a conflict of interest when compan

Services, such as healthcare, public infrastructure, public transport, energy etc should be run by the state. There is always a conflict of interest when companies run these things because they care about profit / shareholder return more than they care about the people. Now, the fact that the state is often corrupt is another problem that should also be fixed but i just don’t buy the argument that companies should run public services because they’re more efficient. The UK is suffering badly with this. I’m old enough to remember how badly some state run things were but i still believe that it was then due to underinvestment as it is with healthcare now.

nopenopenopeno 4y ago
False binary. Under capitalism, the state is always beholden to the interests of capital, i.e. "private" capital.
throw6383878 4y ago
State has conflict of interest as well. It is entity that is trying to save and extract money, just like big corporation. Lets not pretend it is somehow more moral!
- ethanbond 4y ago
  But in democratic states the people also hold the reins on the other end via elections. You don’t get to vote for CEOs or their boards or their boards largest shareholders for $0. So yeah they’re characteristically different.
  - chongli 4y ago
    The problem with state-run healthcare (as well as education) is that costs (especially salaries) can become a political issue. In parts of Canada we’re experiencing severe shortages of healthcare workers (such as nurses) because governments have frozen their pay for political reasons.
    - toomuchtodo 4y ago
      Why does the electorate vote for politicians who won’t pay nurses what they’re worth?
      - chongli 4y ago
        Because they campaign on promises to “cut the fat” from government. Lots of people earn less than nurses and are resentful of that fact.
- sharikous 4y ago
  Yes the point where people have a say is: - state -> elections - corporations -> competition There are many possible scenarios in both cases where the interest of the people becomes irrelevant because of corruption, cartels, etc...
negamax 4y ago
Ireland is another example. Healthcare services have €20B a year budget for 5M population. It's rife with non performance, wrong diagnosis and being borderline ineffective. Element of running a welfare state is how far you take it or make it restrictive so capitalism can thrive. Many doctors run private practice together with their lucrative government jobs. UK on similar level seems lost between running state run programs vs letting private sector thrive. Private sector is certainly not an answer to education and health. But government ones need some private sector like spirit, incentives and sticks. Many of the medical staff don't perform because these are jobs for life with little to no long term effects on their career.
naasking 4y ago
> when companies run these things because they care about profit / shareholder return more than they care about the people. We can accept that without also accepting that governments care about the people either. The top-level care about re-election, and the managers that survive party transitions care about their budgets, their fiefdoms, and maybe sometimes their employees rather than the public write large. Corporations are kept in line with proper competition, where possible. What feedback mechanism is their to keep government bureaucracy in line? Sometimes they have audits, but those are never detailed or frequent enough.
- guerrilla 4y ago
  > Corporations are kept in line with proper competition, where possible. What feedback mechanism is their to keep government bureaucracy in line? Sometimes they have audits, but those are never detailed or frequent enough. No they aren't. This flies in the face of all the evidence right in front of you. They just form cartels and monopolies. The US where everything is private and is the most expensive (by far!!) with the least covered and worst outcomes compared to the one's we're talking about. You're ignoring ALL the evidence just to bolster your ideological nonsense.
  - naasking 4y ago
    > The US where everything is private and is the most expensive (by far!!) with the least covered and worst outcomes compared to the one's we're talking about. You're ignoring ALL the evidence just to bolster your ideological nonsense. Do AMD and Intel have have a cartel, or do they have a healthy competition that drives down prices and improves product quality? That's direct evidence against your claim that a) I'm ignoring "ALL evidence", and b) that all corporations form cartels to avoid competition. The fact that sometimes corporations form cartels does not entail that they always form cartels. The evidence is in fact overwhelming that this usually doesn't happen, but where it does I agree that the government should enforce its competition laws. Finally, you didn't provide an argument refuting the point that government bureaucracy has an equally large problem in monotonic growth. Even if it were true that corporations always formed cartels, which it's not, it's not clear that this would always be a worse situation than that presented by monotonic growth and the inefficiencies that follow. Yes, the US has a serious healthcare problem. Other countries with privatize health insurance don't suffer from these problems, eg. consider Switzerland and Singapore.
nec4b 4y ago
>> Services, such as healthcare, public infrastructure, public transport, energy etc should be run by the state. That is a bold claim and from where I'm standing, it doesn't seem to be rooted in reality. The countries with the best health care system seem to be the ones where insurance (or state) pays for competing doctors. Those countries where doctors only work in state owned hospitals look terrible by comparison.

nopenopenopeno 4y ago

False binary. Under capitalism, the state is always beholden to the interests of capital, i.e. "private" capital.

throw6383878 4y ago

State has conflict of interest as well. It is entity that is trying to save and extract money, just like big corporation. Lets not pretend it is somehow more moral!

ethanbond 4y ago
But in democratic states the people also hold the reins on the other end via elections. You don’t get to vote for CEOs or their boards or their boards largest shareholders for $0. So yeah they’re characteristically different.
- chongli 4y ago
  The problem with state-run healthcare (as well as education) is that costs (especially salaries) can become a political issue. In parts of Canada we’re experiencing severe shortages of healthcare workers (such as nurses) because governments have frozen their pay for political reasons.
  - toomuchtodo 4y ago
    Why does the electorate vote for politicians who won’t pay nurses what they’re worth?
    - chongli 4y ago
      Because they campaign on promises to “cut the fat” from government. Lots of people earn less than nurses and are resentful of that fact.
sharikous 4y ago
Yes the point where people have a say is: - state -> elections - corporations -> competition There are many possible scenarios in both cases where the interest of the people becomes irrelevant because of corruption, cartels, etc...

negamax 4y ago

Ireland is another example. Healthcare services have €20B a year budget for 5M population. It's rife with non performance, wrong diagnosis and being borderline ineffective. Element of running a welfare state is how far you take it or make it restrictive so capitalism can thrive. Many doctors run private practice together with their lucrative government jobs. UK on similar level seems lost between running state run programs vs letting private sector thrive. Private sector is certainly not an answer to education and health. But government ones need some private sector like spirit, incentives and sticks. Many of the medical staff don't perform because these are jobs for life with little to no long term effects on their career.

naasking 4y ago

> when companies run these things because they care about profit / shareholder return more than they care about the people. We can accept that without also accepting that governments care about the people either. The top-level care about re-election, and the managers that survive party transitions care about their budgets, their fiefdoms, and maybe sometimes their employees rather than the public write large. Corporations are kept in line with proper competition, where possible. What feedback mechanism is their to keep government bureaucracy in line? Sometimes they have audits, but those are never detailed or frequent enough.

guerrilla 4y ago
> Corporations are kept in line with proper competition, where possible. What feedback mechanism is their to keep government bureaucracy in line? Sometimes they have audits, but those are never detailed or frequent enough. No they aren't. This flies in the face of all the evidence right in front of you. They just form cartels and monopolies. The US where everything is private and is the most expensive (by far!!) with the least covered and worst outcomes compared to the one's we're talking about. You're ignoring ALL the evidence just to bolster your ideological nonsense.
- naasking 4y ago
  > The US where everything is private and is the most expensive (by far!!) with the least covered and worst outcomes compared to the one's we're talking about. You're ignoring ALL the evidence just to bolster your ideological nonsense. Do AMD and Intel have have a cartel, or do they have a healthy competition that drives down prices and improves product quality? That's direct evidence against your claim that a) I'm ignoring "ALL evidence", and b) that all corporations form cartels to avoid competition. The fact that sometimes corporations form cartels does not entail that they always form cartels. The evidence is in fact overwhelming that this usually doesn't happen, but where it does I agree that the government should enforce its competition laws. Finally, you didn't provide an argument refuting the point that government bureaucracy has an equally large problem in monotonic growth. Even if it were true that corporations always formed cartels, which it's not, it's not clear that this would always be a worse situation than that presented by monotonic growth and the inefficiencies that follow. Yes, the US has a serious healthcare problem. Other countries with privatize health insurance don't suffer from these problems, eg. consider Switzerland and Singapore.

nec4b 4y ago

>> Services, such as healthcare, public infrastructure, public transport, energy etc should be run by the state. That is a bold claim and from where I'm standing, it doesn't seem to be rooted in reality. The countries with the best health care system seem to be the ones where insurance (or state) pays for competing doctors. Those countries where doctors only work in state owned hospitals look terrible by comparison.