4 ms·

Government is probably the worst actor to run healthcare facilities. It’s not that different from PE, except with more administrative bloat. I’d be curious to c

by andy99 9mo ago

Government is probably the worst actor to run healthcare facilities. It’s not that different from PE, except with more administrative bloat. I’d be curious to compare US PE run facilities with government run facilities in Canada. There is not an easy answer here, it basically a cost centre that whoever runs it, the welfare state is incentivized to spend as little as possible on it. PE is almost certainly a bad solution. If they can destroy a restaurant or other low impact business, I hate to think what they’d do to businesses that care for people. You’d get the healthcare equivalent of Burger King. But with government you get the equivalent of the DMV.

cogman10 9mo ago
> I’d be curious to compare US PE run facilities with government run facilities in Canada. You don't have to do that, we have US government ran facilities. It's the VA. And if you look at the costs associated with the VA, they are much much cheaper than almost any private care [1]. And if you know a few vets, you know they almost universally love the VA. It's one of the best perks of serving in the military. [1] https://www.herc.research.va.gov/include/page.asp?ID=inpatient https://www.herc.research.va.gov/include/page.asp?ID=inpatie...
- wisty 9mo ago
  Free market ideologues are too dumb to understand local minima. An ideal free market is a global minima (in theory). It's the best. A non-ideal free market (heavily subsidised and regulated) might be close (in parameter space) to a global minima, but might be highly suboptimal compared to a local minima.
  - messe 9mo ago
    It's not even that. Free markets by themselves (as implemented thus far) DO NOT ACCOUNT FOR EXTERNALITIES. I have yet to see reasonable fix to the tragedy of the commons in a free market situation, and that's one of the most basic things one is fucking introduced to when studying economics and game theory. Anybody who thinks health care is best served solely privately should have to pay to be diagnosed for something; either that or they've been failed in their privately funded education.
    - amanaplanacanal 9mo ago
      In the past I have read some libertarian literature that suggested the answer to the tragedy of the commons was that there should be no commons. Everything should be privately owned. How that would actually work in practice is way beyond my tiny brain.
      - immibis 9mo ago
        It doesn't matter if it works in practice - it's religion, so it doesn't have to be true. We sent rockets up into space and there wasn't a giant man there watching us, but people still believe God exists. We tried living in a free market and everything turned to shit, but people still believe in libertarianism.
        amanaplanacanal 9mo ago
        I think the theory is that if people owned the forest, the rivers, etc, they would have an incentive to take care of them for the long term. As we've seen with how companies have had all the value sucked out of them by private equity, leaving nothing but husks, I think this is a pipe dream.
      - enaaem 9mo ago
        Former libertarian here. The issue with libertarianism is that it does not explain the state of the world. The world is inherently unregulated. If libertarianism was superior it would have outcompeted other systems and it would have been the dominant system right now. Historic explanations are even more problematic. How does libertarianism explain nomadic cultures or rice growing cultures (that tend to be highly collectivist)?
  - tzs 9mo ago
    > Free market ideologues are too dumb to understand local minima …or Nash equilibriums.
hermanzegerman 9mo ago
Government is probably the worst actor to run healthcare facilities Are those your gut feelings, or do you have an argument to back it up? In reality, the outcomes from Government operated hospitals in Scandinavian Countries do not need to hide behind those of other countries, especially not with the US https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
- pixl97 9mo ago
  A better way to put this is "The government is the best entity to run healthcare, except, when the voters elect people who's motto is fuck you, I've got mine"
  - actionfromafar 9mo ago
    So backing up a couple of levels in the conversation here, may I paraphrase. Not "Government is probably the worst actor to run healthcare facilities" but: "Americans are probably the worst actors to run healthcare facilities" I hope it's not true.
messe 9mo ago
[flagged]
wolvoleo 9mo ago
Huh the government is the ideal party to do that. Because it can set its goals to best serve its constituents instead of making money. Don't forget there are so many countries with government healthcare and their care is a lot more accessible than the US's. I've lived in many countries and a nationalised healthcare system is one of the things I select for. Even a poor country like Cuba has one of the highest numbers of doctors per capita. Unfortunately a bit hamstrung by the US's illegal and needless sanctions so they can't get proper equipment but I've been told healthcare is still pretty excellent there.
- immibis 9mo ago
  You're both right: government-run healthcare works okay, except when it's the US government.
  - andy99 9mo ago
    Canadian healthcare is horrible, pretty sure public healthcare in the UK is also very bad. It’s not a given that somehow switching to public healthcare will make the US like Finland, Canada is much more likely.
    - defrost 9mo ago
      It's all about the execution - UK NHS public healthcare was once easily the envy of the world (I'm from Australia, not the UK) and then it suffered decades of being white anted by Conservatives.
      - JumpCrisscross 9mo ago
        > then it suffered decades of being white anted by Conservatives On what planet does this not happen in America?
        defrost 9mo ago
        Of course it happens in the USofA, and more widely in the Americas. The challenge for citizens is active participation in oversight of management of the commons - rats will sneak into every granary otherwise.
zaptheimpaler 9mo ago
Canada's healthcare is generally cheaper per capita, pays healthcare workers less and has far lower administrative costs than the US. The US spends 5x the average of other wealthy countries on administrative costs [1]. This line that the government is automatically inefficient and terrible at anything at all is not true, is not set in stone and does not preclude private industry being even more greedy, stupid, amoral and inefficient than the government. [1] https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...
- messe 9mo ago
  > The US spends 5x the average of other wealthy countries on administrative costs [1]. This line that the government is automatically inefficient and terrible at anything at all is not true It's a line that tends to be mainly parroted by... the US. Quelle fucking surprise.

by andy99 9mo ago

cogman10 9mo ago

> I’d be curious to compare US PE run facilities with government run facilities in Canada. You don't have to do that, we have US government ran facilities. It's the VA. And if you look at the costs associated with the VA, they are much much cheaper than almost any private care [1]. And if you know a few vets, you know they almost universally love the VA. It's one of the best perks of serving in the military. [1] https://www.herc.research.va.gov/include/page.asp?ID=inpatient https://www.herc.research.va.gov/include/page.asp?ID=inpatie...

wisty 9mo ago
Free market ideologues are too dumb to understand local minima. An ideal free market is a global minima (in theory). It's the best. A non-ideal free market (heavily subsidised and regulated) might be close (in parameter space) to a global minima, but might be highly suboptimal compared to a local minima.
- messe 9mo ago
  It's not even that. Free markets by themselves (as implemented thus far) DO NOT ACCOUNT FOR EXTERNALITIES. I have yet to see reasonable fix to the tragedy of the commons in a free market situation, and that's one of the most basic things one is fucking introduced to when studying economics and game theory. Anybody who thinks health care is best served solely privately should have to pay to be diagnosed for something; either that or they've been failed in their privately funded education.
  - amanaplanacanal 9mo ago
    In the past I have read some libertarian literature that suggested the answer to the tragedy of the commons was that there should be no commons. Everything should be privately owned. How that would actually work in practice is way beyond my tiny brain.
    - immibis 9mo ago
      It doesn't matter if it works in practice - it's religion, so it doesn't have to be true. We sent rockets up into space and there wasn't a giant man there watching us, but people still believe God exists. We tried living in a free market and everything turned to shit, but people still believe in libertarianism.
      - amanaplanacanal 9mo ago
        I think the theory is that if people owned the forest, the rivers, etc, they would have an incentive to take care of them for the long term. As we've seen with how companies have had all the value sucked out of them by private equity, leaving nothing but husks, I think this is a pipe dream.
    - enaaem 9mo ago
      Former libertarian here. The issue with libertarianism is that it does not explain the state of the world. The world is inherently unregulated. If libertarianism was superior it would have outcompeted other systems and it would have been the dominant system right now. Historic explanations are even more problematic. How does libertarianism explain nomadic cultures or rice growing cultures (that tend to be highly collectivist)?
- tzs 9mo ago
  > Free market ideologues are too dumb to understand local minima …or Nash equilibriums.

hermanzegerman 9mo ago

Government is probably the worst actor to run healthcare facilities Are those your gut feelings, or do you have an argument to back it up? In reality, the outcomes from Government operated hospitals in Scandinavian Countries do not need to hide behind those of other countries, especially not with the US https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561 https://jamanetwork.com/journals/jamainternalmedicine/fullar...

pixl97 9mo ago
A better way to put this is "The government is the best entity to run healthcare, except, when the voters elect people who's motto is fuck you, I've got mine"
- actionfromafar 9mo ago
  So backing up a couple of levels in the conversation here, may I paraphrase. Not "Government is probably the worst actor to run healthcare facilities" but: "Americans are probably the worst actors to run healthcare facilities" I hope it's not true.

messe 9mo ago

[flagged]

wolvoleo 9mo ago

Huh the government is the ideal party to do that. Because it can set its goals to best serve its constituents instead of making money. Don't forget there are so many countries with government healthcare and their care is a lot more accessible than the US's. I've lived in many countries and a nationalised healthcare system is one of the things I select for. Even a poor country like Cuba has one of the highest numbers of doctors per capita. Unfortunately a bit hamstrung by the US's illegal and needless sanctions so they can't get proper equipment but I've been told healthcare is still pretty excellent there.

immibis 9mo ago
You're both right: government-run healthcare works okay, except when it's the US government.
- andy99 9mo ago
  Canadian healthcare is horrible, pretty sure public healthcare in the UK is also very bad. It’s not a given that somehow switching to public healthcare will make the US like Finland, Canada is much more likely.
  - defrost 9mo ago
    It's all about the execution - UK NHS public healthcare was once easily the envy of the world (I'm from Australia, not the UK) and then it suffered decades of being white anted by Conservatives.
    - JumpCrisscross 9mo ago
      > then it suffered decades of being white anted by Conservatives On what planet does this not happen in America?
      - defrost 9mo ago
        Of course it happens in the USofA, and more widely in the Americas. The challenge for citizens is active participation in oversight of management of the commons - rats will sneak into every granary otherwise.

zaptheimpaler 9mo ago

Canada's healthcare is generally cheaper per capita, pays healthcare workers less and has far lower administrative costs than the US. The US spends 5x the average of other wealthy countries on administrative costs [1]. This line that the government is automatically inefficient and terrible at anything at all is not true, is not set in stone and does not preclude private industry being even more greedy, stupid, amoral and inefficient than the government. [1] https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...

messe 9mo ago
> The US spends 5x the average of other wealthy countries on administrative costs [1]. This line that the government is automatically inefficient and terrible at anything at all is not true It's a line that tends to be mainly parroted by... the US. Quelle fucking surprise.