Americans need to raze their healthcare system down to the ground. None of the bandaid fixes like getting the government to pay but still having private companies dictating the prices. The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, but it's past the financial absurdity at this point, reading about insurance companies literally deciding whether cancer treatment is "strictly necessary" for weeks without approving it is not a healthcare system, it's hell, it's barbarism.
Healthcare has been a political football for decades, with massive interventions by government up and down the stack of services.
Think about the market's provision of grocery stores: plenty of competition. Most places they don't enjoy geographic monopolies like car dealerships do. They manage to get one of the most vital goods to a huge population spread across a huge area on time and at a great price, with local variations anticipating the specific desires of local consumers. There is no central coordinator or Department of Grocery Services. The market figures it out.
How can someone look at healthcare, with its absolutely absurd outcomes, and not understand that it is precisely because of government interference that nothing makes any sense? Costs keep rising unsustainably, which is the opposite of the way markets work. Paperwork and administrative staff balloons in proportion to patient care.
Once the state gets involved, now it becomes political. Do you think the current political climate in the US should be further embedded into healthcare? If the state controlled everything, then you'd get outcomes like red/blue states losing/gaining funding depending on the results of the most recent election. One could imagine more dystopian outcomes quite easily.
You don't seem very familiar with our system of production, distribution, and consumption of food. The government is _very_ involved in all aspects of this. They intervene on the supply side to guarantee prices for commodities. They intervene on the demand side by directly subsidizing 10% of consumers. The federal government inspects all meat, fish, and poultry packed in this country. There is a USDA agent filing a market report every morning from every produce terminal in America. The government maintains a detailed database on soil conditions across the nation. The USDA alone has over 100000 employees. The government also funds a nationwide system of agricultural universities, extensions, and bureaus through the land grant program.
I think if you want to pick some aspect of American life that is free of government involvement, you started in the wrong place.
I had to go to the ER yesterday. I was taken to the closest ER. You bring up geographic monopolies without any irony and yet healthcare has huge and very obvious geographical monopolies.
At the ER I was made to sign something on the way in in a state in which I couldn’t really tell what I was signing. I was given various drugs and sent through a CT scan. I had no idea what was going on. I certainly was in no position, with symptoms of a life threatening condition on top of being incapacitated to say “hey hold up, I think the Safeway has cheaper CT scans can you guys transfer me there!”
Healthcare is entirely different from buying groceries. It does not and will never operate like a typical market for typical commodity items.
The market only provisions grocery stores after massive subsidization, centralization, and exploitative labor. Can you usually purchase cheap local produce for less than that offered by a conglomerate? I'm certain there are useful parallels between healthcare and the grocery market, but I feel like you left them out of your comment. Take bananas for instance: ubiquitous, constantly in demand, sold mostly by two companies, and widely produced by slave labor.
Disclaimer: I'm in favor of a preventative care system available to everyone, regardless of income.
Can you usually purchase cheap local produce for less than that offered by a conglomerate?
You can never purchase local, small batch ____ than you can from large companies. That's why companies get large - they are more efficient the larger they get (to oversimplify).
Your local farmer has much less land than factory farm, and he doesn't have the state of the art equipment to harvest or store his crops. He can't justify spending so much money on equipment when he runs such a small farm.
There's also a good chance he uses "organic" as a selling feature, which means his yeild per area land is way lower than an efficient farm.
He also has to work much harder to actually sell his crop. He doesn't have large commercial deals that put his product directly onto shelves at Aldi. He has to spend half his time driving all over the place to various farmers markets to try and get people to buy his stuff.
You might think all of this is pedantic or obvious, but I think efficiency of food production is very important. Food production is a massive contributor to climate change and opting for methods than can save on land area and water usage can have big impacts.
Or, you do the rational thing that many other nations have done and decide that healthcare is a human right, then stop playing hot potato with the ticking bomb of healthcare.
America is the only one with this very unique problem and going further in the direction of a 'free market' won't work. Because healthcare can never be a free market. The insurers have an incentive to not give quality healthcare and give people the bare minimum while hiding details from customers and no amount of freedom would solve this. The end result is that you'd see something like ISP companies where they work together to enforce a regional monopoly and gouge people all the same.
they don't enjoy geographic monopolies like car dealerships do
This is a bit of a tangent, but do car dealerships have geographic monopolies in some places? I don't think I've even seen just one dealership. They always cluster around each other where I'm from - you could car shop on foot and see at least 3-4 different dealerships.
By brand/corporate representation they do. So you’ll see a cluster of different brands all around the same interchange - but that might be the only, say, Toyota dealership in the area.
How can someone look at healthcare, with its absolutely absurd outcomes, and not understand that it is precisely because of government interference that nothing makes any sense?
Because they see how much of the mess is the markets fault. They also see how nearly every other first world country has a working system while spending less on healtchare. In some places its private non profits subsidized and regulated by the government, in some its the government providing insurance like in Canada, in some it's really socialistic and government employs most doctors like the NHS. In each case the system works much better then the US and the US system is rightly considered a bogeyman. I'm unaware of any place that works like you've described
The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd,
How involved are you with other US government organizations? Do they usually strike you as highly competent and efficient? Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
NOAA and NASA do a great job forecasting weather and tides. The CDC does a ton for public health: no recent pandemics I can recall. The NIH is one of the best biomedical research agencies in the world—-and the NSF, NASA, DoE, and DoD research divisions are no slouches either (GPS, internet, etc). The Library of Congress and Smithsonian make a lot of American heritage accessible to everyone—-and also do serious research of their own. The National Parks are awe-inspiring. The USPS can reliably get something to my family on the other side of the continent for $0.50. The USDA has kept our food supply wholesome, and the FAA/NTSB have made flying—an intrinsically crazy activity, absurdly safe. The SEC and FDIC have keep American markets aboveboard and attractive to investors from around the world.
There’s more to the government than the DMV and taxes.
In fact, if you’ve ever had to interact with the IRS, they are astonishingly pleasant—-I got a question answered and a (small) amount of money refunded in a ten minute phone call. It was vastly better than calling Comcast or the insurance company.
[Edit: enraged_camel said that the VA is pretty good. Is that accurate? I've heard otherwise, but I don't know firsthand. If the VA example isn't accurate, though, replace it with "California high speed rail" or "Amtrak" or "the Department of Education".]
It doesn't have to mean incompetent and inefficient, but it seems that it often does.
People love to act as though government can’t do anything right. Government does plenty of things right, those just don’t get much attention.
I sit here next to my government road with government postal service, lights powered by a private utility heavily regulated by the government, and wish the government provided trash service to me like they do for my neighbor because I’m getting fed up with the shoddy trash service I get from the company I pay, and think, yeah, government health care could be pretty good, just like it is in so many other countries. The US is not uniquely incompetent here.
Along the Northeast corridor, taking Amtrak downtown-to-downtown takes about as long as flying and is vastly more pleasant. The service out west is bad because it's a gongshow of interactions between Amtrak and a bunch of private companies, which seems...oddly reminiscent of something.
My only direct experience with the Department of Education was college financial aid. The FAFSA wasn't particularly awful and I appreciate the help I got--the work study job not only paid for my books and food, but got me started in my career.
Air traffic control is not a great example to cite here. The USA is one of the few countries where the regulator also provides the ATC service. In comparison to Canada, the US government run air traffic control is noticeably less productive and more expensive. Some examples here:
Some more descriptions of the problems with US air traffic control:
...Much of the system still depends on radar technology developed in the 1940s. A new system called NextGen has taken so long to develop and install that controllers are still operating a clunky patchwork that combines antiquated and updated equipment.
...You could hardly find a more egregious example of serial mismanagement than the history of NextGen. Between 2004 and 2006 the FAA spent nearly $26 million just planning the system. Since 2010 it has spent nearly a billion dollars a year on attempting to implement it, frequently missing deadlines and, according to government watchdogs, exceeding budgets.
Between 2004 and 2006 the FAA spent nearly $26 million just planning the system
Or less than .10 USD per American. Nor does spending a billion USD a year since 2010 scream mismanagement to me given the magnitude of the public benefit if it eventually works.
By far the most important barometer of the quality of the US's air-traffic control system is how many fatal collisions there have been between aircraft being controlled by the system, and you haven't offered any data about that.
I agree that safety is paramount here. This is why other countries like Canada have implemented newer technology like GPS flight tracking and digital messaging between pilots and controllers. Improvements like this makes flights safer. In the US, they try to mitigate the dangers of the aging air traffic control system by spacing the planes out further. As the American Airline CEO has said:
“Today to fly from DFW to Philadelphia is about 30 minutes longer than it was in 1979,” Parker said, “simply because we have an [air traffic control] system that hasn’t kept pace with the rest of the world.”
The US is the last major country to still have government act as the regulator and provider of air traffic control. This is an inherent conflict of interest for the regulator that other countries avoid. By having political control of air traffic control, it also means air traffic control is routinely held hostage to government shutdowns and budget impasses which can also impact safety. For example:
Doing a google search on air traffic safety brought up this paper which examined the air traffic control systems of the US and Australia, Germany, New Zealand, and Switzerland:
…An analysis was made to determine the effect privatization had on operating cost and air MIC safety involving the privatized ATC systems of Australia, Germany, New Zealand, and Switzerland. The study showed reduced operating cost and increased safety would result from corporate structuring of the ATC system. It was concluded that corporate style policy regarding personnel management and equipment procurement procedures would increase efficiency, which would reduce operating cost and increase ATC flight safety.
Considering that every other major country has separated the regulation and provision of air traffic control, those who are opposed to it should cite some evidence why the US should be different in this regard.
It goes without saying that you should be skeptical of any argument someone makes, but discounting something solely based on the messenger seems like a logical fallacy.
In the article written by Poole, the data he quotes is from:
...The data source is CANSO’s Global Air Navigation Services Report 2017: The ANSP View. This online document provides the raw data, explains the methodology to construct each key performance indicator (KPI), and notes that all cost numbers have been converted to U.S. dollars, for apples vs. apples comparison. Reviewing the data from all 32 participants in the 2017 report, it is clear that there is some degree of economies of scale, but since costs such as payroll are so much lower in developing countries, metrics involving costs are best compared among ANSPs in countries at the same level of economic development.
Is the data source bad? Was the data inaccurate?
The other article which goes into more detail is not associated with Bob Poole.
Logical fallacies deal in absolutes. "This is false because the person making the claim is..." is a logical fallacy. "I'm skeptical and don't find this to be convincing because the person making the claim is..." is not.
We all have to apply heuristics to the information we take in, because there's far too much to be rigorously logical to it all. And my heuristic here is that libertarians in general and Reason in particular are not typically purveyors of good arguments, and this is very clearly an ideologically motivated argument, not a dispassionate analysis. Ideologically motivated arguments can be correct, but they're much less likely to be.
I'm sure the data is just fine. Interpreting it is tricky. The US and Canada are such vastly different countries. For example, Canada has a huge number of flights passing over it without stopping there (lots of flights between the US and Europe and Asia pass over Canada) and ATC for flights in cruise is vastly easier than ATC for flights descending to land or climbing to cruise. Does this actually make a significant difference? I have no idea. But the fact that this isn't even mentioned in the article, nor are any other potential explanations for the difference other than the supposed inherent superiority of privatization, makes it suspect.
At any rate, privatized ATC is still under strict government regulation and control, so they really just show us another effective model for socialized health care, rather than serving as an argument against it.
If there's a country where ATC is run by many different competing businesses with wide latitude in how they operate, and that country's ATC is better, then that would be another matter. I doubt there are any.
Disagree. You preemptively publicly say that you "are skeptical" because of something irrelevant to the argument and don't address anything I brought up - that is kind of the definition of poisoning the well.
...To commit a preemptive ad hominem attack against an opponent. That is, to prime the audience with adverse information about the opponent from the start, in an attempt to make your claim more acceptable or discount the credibility of your opponent’s claim.
...For example, Canada has a huge number of flights passing over it without stopping there (lots of flights between the US and Europe and Asia pass over Canada) and ATC for flights in cruise is vastly easier than ATC for flights descending to land or climbing to cruise.
This is odd speculation on your part. Doing a google search on air traffic safety brought up this paper which examined the air traffic control systems of the US and Australia, Germany, New Zealand, and Switzerland:
…An analysis was made to determine the effect privatization had on operating cost and air MIC safety involving the privatized ATC systems of Australia, Germany, New Zealand, and Switzerland. The study showed reduced operating cost and increased safety would result from corporate structuring of the ATC system. It was concluded that corporate style policy regarding personnel management and equipment procurement procedures would increase efficiency, which would reduce operating cost and increase ATC flight safety.
...At any rate, privatized ATC is still under strict government regulation and control, so they really just show us another effective model for socialized health care, rather than serving as an argument against it.
Most people don't associate the idea of "socialized health care" with the regulatory bodies that exist like the FDA. Most people would not say we have "socialized nuclear power" just because the NRC regulates nuclear power plants, etc.
...If there's a country where ATC is run by many different competing businesses with wide latitude in how they operate, and that country's ATC is better, then that would be another matter. I doubt there are any.
Straw man. I didn't claim there was. What I said was "Air traffic control is not a great example to cite here. The USA is one of the few countries where the regulator also provides the ATC service." and I cited 2 articles showing how it is less efficient and behind other countries. Your claim was that it was "superb".
Considering that every other major country has separated the regulation and provision of air traffic control, if you want to claim the current ATC system is "superb", you should provide some evidence why you think that.
I thought the evidence was pretty clear: the safety record of American ATC is nearly perfect and delays caused by ATC are nearly nonexistent.
As far as "socialized health care," there are many different models for it. The oft-discussed "medicare for all" plan would be a system where regulated private entities provide health care and the government pays for it. Another common model involves public and private insurance and private providers, regulated to provide for universal service (essentially the ACA, but less crappy). If "socialized health care" means the government directly runs it all, then that excludes most countries commonly considered to have it, including Canada, Australia, and most of Europe. I realize that the comment I originally replied to specifically discussed government owned health care from top to bottom, but I'm expanding the discussion to include more real-world models. I think one of the big problems with this discussion in the US is our complete unwillingness to look at what other countries do and how they work, and there are a variety of different examples to consider there.
I thought the evidence was pretty clear: the safety record of American ATC is nearly perfect and delays caused by ATC are nearly nonexistent.
As I noted elsewhere, other countries like Canada have implemented technology like GPS flight tracking and digital messaging between pilots and controllers which makes flights safer. In the US, they try to mitigate the dangers of the aging air traffic control system by spacing the planes out further. You might not notice the inefficiencies being put into the system, but as the American Airline CEO has said:
“Today to fly from DFW to Philadelphia is about 30 minutes longer than it was in 1979,” Parker said, “simply because we have an [air traffic control] system that hasn’t kept pace with the rest of the world.”
At a minimum these kinds of inefficiencies result in more pollution and higher ticket prices.
By having political control of air traffic control, it also means air traffic control is routinely held hostage to government shutdowns and budget impasses which can also impact safety. For example:
These sorts of things don't make air travel more safe - they make it less safe.
Having the regulator regulate themselves is an inherent conflict of interest. For example, this paper done by the NTSB a long time ago addresses the issue of the lack of study of ATC failures:
…However, current accident and incident reporting systems were not designed with ATC errors in mind, making the analysis of latent factors, such as supervisory and organizational issues, extremely difficult. What is needed is a new error-analysis framework that will facilitate the gathering of information during ATC related accident and incident investigations ...
Does anyone actually think having the regulator regulate themselves is a good long term approach?
In terms of your comments health care reform, you make some good points, but your argument deserves a HN discussion all its own. In this one, I am simply trying to show that the current ATC system in the US is not an example of "a superb" government program and I would say it should be reformed to be more like every other major country.
The US government is alone among major countries of being the regulator and provider of air traffic control. In comparison to other countries we have higher costs, less efficiency and arguably less safety. The first proposal to break out the regulation of air traffic control with the provision of the air traffic control was done by the Clinton administration. Support since then has been bipartisan and opposition has also been from members of both parties for various reasons. (I read somewhere that one of the biggest long time opponents of breaking out the air traffic control has been the associations of owners of private jets as they currently pay about 1% of the cost of ATC, but are closer to 10% of the flights in major airports. In reality, owners of private jets can likely afford to pay a more proportional percentage of the costs they impose on the system.)
In the end, it i disappointing to see people immediately reject the idea without even examining the evidence. If we can't reform something this blatantly obvious, I wonder how we will ever come to a resolution on big complex issues facing the country. Those who want to keep the status quo on air traffic control should provide some evidence why having a self regulator who relies on decades old technology and is more costly than other countries is the best we can do for air traffic control.
>And based on the scandal around the VA a few years ago, no it wasn’t well run at all.
Scandals aren't unique to government. The private sector has them all the time. In fact, sometimes private sector scandals are so massive they crash the entire economy.
Of course, but the VA is the largest gov’t run healthcare system in the US and the scandal impacted tens of thousands of veterans. Doesn’t exactly engender confidence.
Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
Most people on Medicare are generally quite happy with it. The idiocies generally start when the government let private companies get involved (Medicare Part D).
In addition, the person who brought "socialized medicine" to Canada is regarded as as a hero.
At the rate we are going, whoever finally brings Medicare to everyone in the US will be regarded as a hero as well. I have what qualifies as pretty good coverage by US standards and I still won't shed a single tear when it gets replaced with single payer. In fact I look forward to having more flexibility to switch jobs or start my own business without having that consideration.
Decent vision means less chance of falling and breaking bones, and yet new research reveals a heartbreaking state of affairs – the NHS is rationing routine operations that can restore sight, by categorising the procedure as “non-essential”. As a result of this misguided policy, hundreds of thousands of people are currently marooned at home with cataracts, their lives diminished by NHS pen-pushers callously deciding their condition isn’t life-threatening. Cataracts might not be “life-threatening” but they are most definitely “life-diminishing”. https://www.independent.co.uk/voices/scandal-nhs-eye-operati...
Comments
Americans need to raze their healthcare system down to the ground. None of the bandaid fixes like getting the government to pay but still having private companies dictating the prices. The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, but it's past the financial absurdity at this point, reading about insurance companies literally deciding whether cancer treatment is "strictly necessary" for weeks without approving it is not a healthcare system, it's hell, it's barbarism.
Healthcare has been a political football for decades, with massive interventions by government up and down the stack of services.
Think about the market's provision of grocery stores: plenty of competition. Most places they don't enjoy geographic monopolies like car dealerships do. They manage to get one of the most vital goods to a huge population spread across a huge area on time and at a great price, with local variations anticipating the specific desires of local consumers. There is no central coordinator or Department of Grocery Services. The market figures it out.
How can someone look at healthcare, with its absolutely absurd outcomes, and not understand that it is precisely because of government interference that nothing makes any sense? Costs keep rising unsustainably, which is the opposite of the way markets work. Paperwork and administrative staff balloons in proportion to patient care.
Once the state gets involved, now it becomes political. Do you think the current political climate in the US should be further embedded into healthcare? If the state controlled everything, then you'd get outcomes like red/blue states losing/gaining funding depending on the results of the most recent election. One could imagine more dystopian outcomes quite easily.
You don't seem very familiar with our system of production, distribution, and consumption of food. The government is _very_ involved in all aspects of this. They intervene on the supply side to guarantee prices for commodities. They intervene on the demand side by directly subsidizing 10% of consumers. The federal government inspects all meat, fish, and poultry packed in this country. There is a USDA agent filing a market report every morning from every produce terminal in America. The government maintains a detailed database on soil conditions across the nation. The USDA alone has over 100000 employees. The government also funds a nationwide system of agricultural universities, extensions, and bureaus through the land grant program.
I think if you want to pick some aspect of American life that is free of government involvement, you started in the wrong place.
I had to go to the ER yesterday. I was taken to the closest ER. You bring up geographic monopolies without any irony and yet healthcare has huge and very obvious geographical monopolies.
At the ER I was made to sign something on the way in in a state in which I couldn’t really tell what I was signing. I was given various drugs and sent through a CT scan. I had no idea what was going on. I certainly was in no position, with symptoms of a life threatening condition on top of being incapacitated to say “hey hold up, I think the Safeway has cheaper CT scans can you guys transfer me there!”
Healthcare is entirely different from buying groceries. It does not and will never operate like a typical market for typical commodity items.
Emergency medicine is a small fraction of all medicinal needs.
A lot of medicinal procedures allow time for determining what the most cost effective offering is.
But is the ideal system one with several hospitals per city, duplicating expensive resources or one big centre with centralised resources?
The market only provisions grocery stores after massive subsidization, centralization, and exploitative labor. Can you usually purchase cheap local produce for less than that offered by a conglomerate? I'm certain there are useful parallels between healthcare and the grocery market, but I feel like you left them out of your comment. Take bananas for instance: ubiquitous, constantly in demand, sold mostly by two companies, and widely produced by slave labor.
Disclaimer: I'm in favor of a preventative care system available to everyone, regardless of income.
You can never purchase local, small batch ____ than you can from large companies. That's why companies get large - they are more efficient the larger they get (to oversimplify).
Your local farmer has much less land than factory farm, and he doesn't have the state of the art equipment to harvest or store his crops. He can't justify spending so much money on equipment when he runs such a small farm.
There's also a good chance he uses "organic" as a selling feature, which means his yeild per area land is way lower than an efficient farm.
He also has to work much harder to actually sell his crop. He doesn't have large commercial deals that put his product directly onto shelves at Aldi. He has to spend half his time driving all over the place to various farmers markets to try and get people to buy his stuff.
You might think all of this is pedantic or obvious, but I think efficiency of food production is very important. Food production is a massive contributor to climate change and opting for methods than can save on land area and water usage can have big impacts.
Or, you do the rational thing that many other nations have done and decide that healthcare is a human right, then stop playing hot potato with the ticking bomb of healthcare.
America is the only one with this very unique problem and going further in the direction of a 'free market' won't work. Because healthcare can never be a free market. The insurers have an incentive to not give quality healthcare and give people the bare minimum while hiding details from customers and no amount of freedom would solve this. The end result is that you'd see something like ISP companies where they work together to enforce a regional monopoly and gouge people all the same.
Veterinary services and dentistry aren't in the same situation though.
And you can have both a public option alongside a free market.
Honest question - are there any successful healthcare systems that have more privatization than the US?
This is a bit of a tangent, but do car dealerships have geographic monopolies in some places? I don't think I've even seen just one dealership. They always cluster around each other where I'm from - you could car shop on foot and see at least 3-4 different dealerships.
By brand/corporate representation they do. So you’ll see a cluster of different brands all around the same interchange - but that might be the only, say, Toyota dealership in the area.
Ah, that makes more sense. Thank you!
Because they see how much of the mess is the markets fault. They also see how nearly every other first world country has a working system while spending less on healtchare. In some places its private non profits subsidized and regulated by the government, in some its the government providing insurance like in Canada, in some it's really socialistic and government employs most doctors like the NHS. In each case the system works much better then the US and the US system is rightly considered a bogeyman. I'm unaware of any place that works like you've described
Please define "works much better." Thanks.
How involved are you with other US government organizations? Do they usually strike you as highly competent and efficient? Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
Yes, actually.
NOAA and NASA do a great job forecasting weather and tides. The CDC does a ton for public health: no recent pandemics I can recall. The NIH is one of the best biomedical research agencies in the world—-and the NSF, NASA, DoE, and DoD research divisions are no slouches either (GPS, internet, etc). The Library of Congress and Smithsonian make a lot of American heritage accessible to everyone—-and also do serious research of their own. The National Parks are awe-inspiring. The USPS can reliably get something to my family on the other side of the continent for $0.50. The USDA has kept our food supply wholesome, and the FAA/NTSB have made flying—an intrinsically crazy activity, absurdly safe. The SEC and FDIC have keep American markets aboveboard and attractive to investors from around the world.
There’s more to the government than the DMV and taxes.
In fact, if you’ve ever had to interact with the IRS, they are astonishingly pleasant—-I got a question answered and a (small) amount of money refunded in a ten minute phone call. It was vastly better than calling Comcast or the insurance company.
We could choose to staff them with competent people instead of deliberately sabotaging it. There are viable alternatives to the GOP strategy.
If only someone had thought of that before
Maybe we could run it similarly to the government-run air traffic control system, which is superb.
“Government” doesn’t have to mean “incompetent and inefficient.”
Maybe we could. Or maybe we'd run it like the VA.
[Edit: enraged_camel said that the VA is pretty good. Is that accurate? I've heard otherwise, but I don't know firsthand. If the VA example isn't accurate, though, replace it with "California high speed rail" or "Amtrak" or "the Department of Education".]
It doesn't have to mean incompetent and inefficient, but it seems that it often does.
How often?
People love to act as though government can’t do anything right. Government does plenty of things right, those just don’t get much attention.
I sit here next to my government road with government postal service, lights powered by a private utility heavily regulated by the government, and wish the government provided trash service to me like they do for my neighbor because I’m getting fed up with the shoddy trash service I get from the company I pay, and think, yeah, government health care could be pretty good, just like it is in so many other countries. The US is not uniquely incompetent here.
That gov’t road was likely built by a private company. And being heavily regulated doesn’t make a private utility a good example.
Fair point.
Along the Northeast corridor, taking Amtrak downtown-to-downtown takes about as long as flying and is vastly more pleasant. The service out west is bad because it's a gongshow of interactions between Amtrak and a bunch of private companies, which seems...oddly reminiscent of something.
My only direct experience with the Department of Education was college financial aid. The FAFSA wasn't particularly awful and I appreciate the help I got--the work study job not only paid for my books and food, but got me started in my career.
Perhaps we could call it "Medicare" and it would be way more efficient than any of the private insurers.
Air traffic control is not a great example to cite here. The USA is one of the few countries where the regulator also provides the ATC service. In comparison to Canada, the US government run air traffic control is noticeably less productive and more expensive. Some examples here:
https://jdasolutions.aero/blog/guest-author-robert-poole-faa...
Some more descriptions of the problems with US air traffic control:
https://www.thedailybeast.com/lobbyists-and-congress-just-ki...
Or less than .10 USD per American. Nor does spending a billion USD a year since 2010 scream mismanagement to me given the magnitude of the public benefit if it eventually works.
By far the most important barometer of the quality of the US's air-traffic control system is how many fatal collisions there have been between aircraft being controlled by the system, and you haven't offered any data about that.
I agree that safety is paramount here. This is why other countries like Canada have implemented newer technology like GPS flight tracking and digital messaging between pilots and controllers. Improvements like this makes flights safer. In the US, they try to mitigate the dangers of the aging air traffic control system by spacing the planes out further. As the American Airline CEO has said:
https://www.dallasnews.com/business/american-airlines/2017/0...
This wired article also has some more background on the US air traffic control system:
https://www.wired.com/2015/02/air-traffic-control/
The US is the last major country to still have government act as the regulator and provider of air traffic control. This is an inherent conflict of interest for the regulator that other countries avoid. By having political control of air traffic control, it also means air traffic control is routinely held hostage to government shutdowns and budget impasses which can also impact safety. For example:
https://www.theatlantic.com/ideas/archive/2019/01/how-shutdo...
Doing a google search on air traffic safety brought up this paper which examined the air traffic control systems of the US and Australia, Germany, New Zealand, and Switzerland:
https://commons.erau.edu/cgi/viewcontent.cgi?article=1521&co...
Considering that every other major country has separated the regulation and provision of air traffic control, those who are opposed to it should cite some evidence why the US should be different in this regard.
I hope you’ll forgive me for being skeptical of arguments for ATC privatization from the founder of Reason.
It goes without saying that you should be skeptical of any argument someone makes, but discounting something solely based on the messenger seems like a logical fallacy.
In the article written by Poole, the data he quotes is from:
Is the data source bad? Was the data inaccurate?
The other article which goes into more detail is not associated with Bob Poole.
Logical fallacies deal in absolutes. "This is false because the person making the claim is..." is a logical fallacy. "I'm skeptical and don't find this to be convincing because the person making the claim is..." is not.
We all have to apply heuristics to the information we take in, because there's far too much to be rigorously logical to it all. And my heuristic here is that libertarians in general and Reason in particular are not typically purveyors of good arguments, and this is very clearly an ideologically motivated argument, not a dispassionate analysis. Ideologically motivated arguments can be correct, but they're much less likely to be.
I'm sure the data is just fine. Interpreting it is tricky. The US and Canada are such vastly different countries. For example, Canada has a huge number of flights passing over it without stopping there (lots of flights between the US and Europe and Asia pass over Canada) and ATC for flights in cruise is vastly easier than ATC for flights descending to land or climbing to cruise. Does this actually make a significant difference? I have no idea. But the fact that this isn't even mentioned in the article, nor are any other potential explanations for the difference other than the supposed inherent superiority of privatization, makes it suspect.
At any rate, privatized ATC is still under strict government regulation and control, so they really just show us another effective model for socialized health care, rather than serving as an argument against it.
If there's a country where ATC is run by many different competing businesses with wide latitude in how they operate, and that country's ATC is better, then that would be another matter. I doubt there are any.
Disagree. You preemptively publicly say that you "are skeptical" because of something irrelevant to the argument and don't address anything I brought up - that is kind of the definition of poisoning the well.
https://www.logicallyfallacious.com/tools/lp/Bo/LogicalFalla...
This is odd speculation on your part. Doing a google search on air traffic safety brought up this paper which examined the air traffic control systems of the US and Australia, Germany, New Zealand, and Switzerland:
https://commons.erau.edu/cgi/viewcontent.cgi?article=1521&co...
Most people don't associate the idea of "socialized health care" with the regulatory bodies that exist like the FDA. Most people would not say we have "socialized nuclear power" just because the NRC regulates nuclear power plants, etc.
Straw man. I didn't claim there was. What I said was "Air traffic control is not a great example to cite here. The USA is one of the few countries where the regulator also provides the ATC service." and I cited 2 articles showing how it is less efficient and behind other countries. Your claim was that it was "superb".
Considering that every other major country has separated the regulation and provision of air traffic control, if you want to claim the current ATC system is "superb", you should provide some evidence why you think that.
I thought the evidence was pretty clear: the safety record of American ATC is nearly perfect and delays caused by ATC are nearly nonexistent.
As far as "socialized health care," there are many different models for it. The oft-discussed "medicare for all" plan would be a system where regulated private entities provide health care and the government pays for it. Another common model involves public and private insurance and private providers, regulated to provide for universal service (essentially the ACA, but less crappy). If "socialized health care" means the government directly runs it all, then that excludes most countries commonly considered to have it, including Canada, Australia, and most of Europe. I realize that the comment I originally replied to specifically discussed government owned health care from top to bottom, but I'm expanding the discussion to include more real-world models. I think one of the big problems with this discussion in the US is our complete unwillingness to look at what other countries do and how they work, and there are a variety of different examples to consider there.
As I noted elsewhere, other countries like Canada have implemented technology like GPS flight tracking and digital messaging between pilots and controllers which makes flights safer. In the US, they try to mitigate the dangers of the aging air traffic control system by spacing the planes out further. You might not notice the inefficiencies being put into the system, but as the American Airline CEO has said:
https://www.dallasnews.com/business/american-airlines/2017/0...
At a minimum these kinds of inefficiencies result in more pollution and higher ticket prices.
By having political control of air traffic control, it also means air traffic control is routinely held hostage to government shutdowns and budget impasses which can also impact safety. For example:
https://www.theatlantic.com/ideas/archive/2019/01/how-shutdo...
This article talks about how LaGuardia was shut down due to the government shutdown:
https://www.zdnet.com/article/how-the-air-traffic-control-sy...
These sorts of things don't make air travel more safe - they make it less safe.
Having the regulator regulate themselves is an inherent conflict of interest. For example, this paper done by the NTSB a long time ago addresses the issue of the lack of study of ATC failures:
https://www.faa.gov/about/initiatives/maintenance_hf/library...
later we see:
These recommendations were prompted by analyzing _4_ previous accidents.
https://en.wikipedia.org/wiki/Comair_Flight_5191
Yet this quora discussion implies that fatigue and the unwillingness to report mistakes are still a problem at the agency:
https://www.quora.com/What-is-the-penalty-to-air-traffic-con...
Does anyone actually think having the regulator regulate themselves is a good long term approach?
In terms of your comments health care reform, you make some good points, but your argument deserves a HN discussion all its own. In this one, I am simply trying to show that the current ATC system in the US is not an example of "a superb" government program and I would say it should be reformed to be more like every other major country.
The US government is alone among major countries of being the regulator and provider of air traffic control. In comparison to other countries we have higher costs, less efficiency and arguably less safety. The first proposal to break out the regulation of air traffic control with the provision of the air traffic control was done by the Clinton administration. Support since then has been bipartisan and opposition has also been from members of both parties for various reasons. (I read somewhere that one of the biggest long time opponents of breaking out the air traffic control has been the associations of owners of private jets as they currently pay about 1% of the cost of ATC, but are closer to 10% of the flights in major airports. In reality, owners of private jets can likely afford to pay a more proportional percentage of the costs they impose on the system.)
In the end, it i disappointing to see people immediately reject the idea without even examining the evidence. If we can't reform something this blatantly obvious, I wonder how we will ever come to a resolution on big complex issues facing the country. Those who want to keep the status quo on air traffic control should provide some evidence why having a self regulator who relies on decades old technology and is more costly than other countries is the best we can do for air traffic control.
Far from all but,a decent number of them yes
Medicare and VA, while not perfect, are both well-run and extremely popular. So yes, the US government is in fact capable of handling healthcare.
Much of the Medicare business is funded by the gov’t, but executed by private insurers (Part C and Part D).
And based on the scandal around the VA a few years ago, no it wasn’t well run at all.
Scandals aren't unique to government. The private sector has them all the time. In fact, sometimes private sector scandals are so massive they crash the entire economy.
Of course, but the VA is the largest gov’t run healthcare system in the US and the scandal impacted tens of thousands of veterans. Doesn’t exactly engender confidence.
I tell myself there are easily hundreds or thousands of Front Page NYT stories every day, but they never leak to the public.
Most people on Medicare are generally quite happy with it. The idiocies generally start when the government let private companies get involved (Medicare Part D).
In addition, the person who brought "socialized medicine" to Canada is regarded as as a hero.
Talking points without citation are not data.
At the rate we are going, whoever finally brings Medicare to everyone in the US will be regarded as a hero as well. I have what qualifies as pretty good coverage by US standards and I still won't shed a single tear when it gets replaced with single payer. In fact I look forward to having more flexibility to switch jobs or start my own business without having that consideration.