2020 US Election

[caze]

some bureaucracy is obviously important, we need competent experts to get on with doing the job, but bureaucracies tend to grow unnecessarily if left unattended, and it's easier to deal with that problem in the private sector when it happens than in the public sector.

[Limo]

1 minute ago, caze said:

some bureaucracy is obviously important, we need competent experts to get on with doing the job, but bureaucracies tend to grow unnecessarily if left unattended, and it's easier to deal with that problem in the private sector when it happens than in the public sector.

Again - provide sources please otherwise this is just libertarian propaganda.

[dingformung]

1 minute ago, caze said:

some bureaucracy is obviously important, we need competent experts to get on with doing the job, but bureaucracies tend to grow unnecessarily if left unattended, and it's easier to deal with that problem in the private sector when it happens than in the public sector.

Sure, but state bureaucracy is the (watered down) will of the electorate while in the private sector more often than not it is mere social darwinism, if not regulated (and regulation means bureaucracy)

[Limo]

27 minutes ago, caze said:

the entire history of the modern world. this isn't entirely the government's fault, it's largely a natural consequence of 'stuff' getting cheaper to manufacture, while people get more expensive to pay, thanks to rising living standards and other things. the private sector is just more agile when it comes to dealing with these problems than governments (as long as they're not trapped into some corrupt monopoly situation themselves), and governments tend to revel in increasing the size of their bureaucracy, so I'm sceptical about their claims on reducing inefficiencies in the private sector, just as likely they'll replace them with their own versions.

This is not a source, this is hand waving. Please cite specific examples of "the private sector" being "more agile" and governments "[tending] to revel in increasing the size of their bureaucracy".

 

I've seen plenty of very efficient government agencies (the US postal service, for one) and plenty of private sector entities with increasing bureaucracies. For the latter, just consider where Google or Microsoft began and what they are now (huge, inefficient bureaucratic molochs).

Edited April 17, 2020 by rhmilo
added US postal service as an example of an efficient government agency

[goDel]

23 minutes ago, rhmilo said:

Again - provide sources please otherwise this is just libertarian propaganda.

Ehm, as i'm currently working for the government i can tell you there's truth to the stereotype. i really don't see why you need strong evidence for caze's comments to be justified. even from within the government this is an accepted notion. governments tend to be inefficient and inflexible. there's lots of reasons why. honestly not interested to get into it. but there's def a core of truth. maybe not as bad as the typical us ideologues might argue. but that's because the us discussion is being "skewed". generally speaking, laws create a lot of hassle and inefficiency. almost by nature. add the inefficiency of the organisation itself, and you get an idea why theres some truth to the stereotype.

Edited April 17, 2020 by goDel

[caze]

lol, I'm not a libertarian. criticism of bureaucracy started with Max Weber ffs. I also never said private companies were immune to the problems with growing bureaucracies, I explicitly stated they fell victim to it as well (and that they were unlikely to get out of them if they in a corrupt/monopolistic situation - which is part of the explanation for the high cost of private health insurance in the US - thanks to state-level protectionism for example).

The US postal service is not a great advert for finely tuned efficiency btw, the mail is a dying industry worldwide, and the US postal service is currently undergoing a major restructuring due to that fact.

[Limo]

17 minutes ago, goDel said:

Ehm, as i'm currently working for the government i can tell you there's truth to the stereotype. i really don't see why you need strong evidence for caze's comments to be justified. even from within the government this is an accepted notion. governments tend to be inefficient and inflexible. there's lots of reasons why. honestly not interested to get into it. but there's def a core of truth. maybe not as bad as the typical us ideologues might argue. but that's because the us discussion is being "skewed". generally speaking, laws create a lot of hassle and inefficiency. almost by nature. add the inefficiency of the organisation itself, and you get an idea why theres some truth to the stereotype.

I've worked for the private sector for half of my professional life and I can assure you that once a company gets big enough you get exactly the same problems of inaction and swelling bureaucracies.

If anything, I've found government agencies to be a bit more pleasant to work with because at least the people there did not fear for their jobs as much (I'm assuming) so they were more willing to bend the rules and be flexible to get things done.

[goDel]

13 minutes ago, rhmilo said:

I've worked for the private sector for half of my professional life and I can assure you that once a company gets big enough you get exactly the same problems of inaction and swelling bureaucracies.

If anything, I've found government agencies to be a bit more pleasant to work with because at least the people there did not fear for their jobs as much (I'm assuming) so they were more willing to bend the rules and be flexible to get things done.

Well thats the point, isn't it. In the private sector you should/could fear for your job. Especially when your part of the inefficiency. In the public sector you have nothing to fear. Which is one of the reasons why the government is so bloated and inefficient. People can freeride without fear of losing their job. It's just silly. This also makes the government operate suboptimal, to say the least. Not saying the private sector is without its flaws. I've spent plenty years in the private sector as well. Ideally youd want a bit of both. (also note that's part of the reason why so many countries end up with a mixed healthcare system)

Edited April 17, 2020 by goDel

[chenGOD]

2 hours ago, Mesh Gear Fox said:

ah ok, well i meant public healthcare, i.e. having a system that doesn't involve private companies ripping people off as basically the only option you get. kinda like what we have here in aus.

• Giving Americans a new choice, a public health insurance option like Medicare. If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying your insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees.

As more people move to Medicare (which they will due to insurance companies being for profit and Medicare being not), it will have more negotiating power due to economies of scale. It will ultimately lead to something like what exists in Canada and I think Australia.

[dingformung]

8 minutes ago, goDel said:

People can freeride without fear of losing their job. It's just silly. 

Fear, it's just really good

[Nebraska]

never thought MS-13 gang members voted but nice to see they're active in politics. i wonder if they keep up with the debates as well or they just go with who they think will look out for their special interests

[chenGOD]

2 hours ago, caze said:

there are only two non-commie/authoritarian countries in the world with fully public health care systems, the UK and Norway (Sweden/Denmark also have publicly health care provision, but with more private insurance). Australia has a mixed system (both in terms of provision and insurance), very different to what Bernie was proposing. More countries have single-payer systems, with either mixed or private provision set ups, but M4A was significantly more radical than any of those as well (it's very rare to attempt to ban virtually all private insurance, rare and also a terrible idea). fully public health care is a recipe for disaster, it's very expensive, tends to be badly managed and has poorer outcomes than mixed systems, which is probably why 'centrists' are no longer keen on the idea, if something has proven to be a bad idea, don't do it!

Canada is largely public health, outside of dental, but there is a push to bring that into the public health sphere.

[goDel]

7 minutes ago, chenGOD said:

• Giving Americans a new choice, a public health insurance option like Medicare. If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying your insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees.

As more people move to Medicare (which they will due to insurance companies being for profit and Medicare being not), it will have more negotiating power due to economies of scale. It will ultimately lead to something like what exists in Canada and I think Australia.

also note that under the (original) ACA private healthinsurance companies were limited in the extent they could make a profit. if they exceeded a percentage, they had to return money to the people with an insurance. not sure if that still holds today, as the current government is hellbent to destroy the ACA. But originally, people were protected.

[caze]

39 minutes ago, rhmilo said:

I've worked for the private sector for half of my professional life and I can assure you that once a company gets big enough you get exactly the same problems of inaction and swelling bureaucracies.

The majority of the private sector is made up of small to medium sized businesses, so when I say the private sector is more agile, this is what I'm referring to, not big monolithic companies. As long as there's not too much corruption or monopolisation then there will always be opportunities for smaller and more efficient companies to lower costs and improve efficiencies over all.

[chenGOD]

8 minutes ago, caze said:

The majority of the private sector is made up of small to medium sized businesses, so when I say the private sector is more agile, this is what I'm referring to, not big monolithic companies. As long as there's not too much corruption or monopolisation then there will always be opportunities for smaller and more efficient companies to lower costs and improve efficiencies over all.

Insurance doesn't work that way though - economies of scale play a large factor in the ability of insurance companies to negotiate with hospitals. A small insurance company has no chance to compete with a big player, in terms of winning contracts from health service providers.

[caze]

24 minutes ago, chenGOD said:

Canada is largely public health, outside of dental, but there is a push to bring that into the public health sphere.

In terms of provision it's mostly private, no? It's single payer (bar around 20% private insurance for certain things) not a fully public health service. UK/Nordic countries do the whole thing publicly (with varying levels of private input in certain places), Australia//NZ have a more a mixed system, and Canada is different again, similar to Taiwan and South Korea (mostly publicly funded, privately operated - some form of this would probably the easiest system for the US to move to, but it doesn't need to do it overnight, it could reform and decrease the dependence on private insurance over time).

[caze]

3 minutes ago, chenGOD said:

Insurance doesn't work that way though - economies of scale play a large factor in the ability of insurance companies to negotiate with hospitals. A small insurance company has no chance to compete with a big player, in terms of winning contracts from health service providers.

That's the way it works in the US though, because of state level protectionism. Increased competition would probably see a mixture of consolidation of larger companies and some smaller companies getting much bigger (and others going bankrupt), all of which should reduce costs for the patients. Increased competition from a public option would also help keep costs down.

[chenGOD]

16 minutes ago, caze said:

That's the way it works in the US though, because of state level protectionism. Increased competition would probably see a mixture of consolidation of larger companies and some smaller companies getting much bigger (and others going bankrupt), all of which should reduce costs for the patients. Increased competition from a public option would also help keep costs down.

If they were starting from nil in an ideal world maybe, but you already have existing monoliths in the insurance industry.

[caze]

5 minutes ago, chenGOD said:

If they were starting from nil in an ideal world maybe, but you already have existing monoliths in the insurance industry.

The US has nearly 1,000 health insurance companies, and only a single company with more than 10% market share. There is plenty of scope for a radical shakeup of the market. 

[chenGOD]

25 minutes ago, caze said:

In terms of provision it's mostly private, no? It's single payer (bar around 20% private insurance for certain things) not a fully public health service. UK/Nordic countries do the whole thing publicly (with varying levels of private input in certain places), Australia//NZ have a more a mixed system, and Canada is different again, similar to Taiwan and South Korea (mostly publicly funded, privately operated - some form of this would probably the easiest system for the US to move to, but it doesn't need to do it overnight, it could reform and decrease the dependence on private insurance over time).

Define private? Doctors and clinics incorporate often, but the public doesn't pay for service provision directly. There is serious discussion to incorporate funding for the remaining pieces such as dental and prescription drugs to the publicly funded model. Hospitals are generally run by charities, and funded by the government. For all intents and purposes, to the general public, it's a public health service.

[chenGOD]

3 minutes ago, caze said:

The US has nearly 1,000 health insurance companies, and only a single company with more than 10% market share. There is plenty of scope for a radical shakeup of the market. 

5 companies control almost 40% of the market. Continuing with competition will inevitably lead to consolidation like you saw in media companies.

[Limo]

2 hours ago, caze said:

The majority of the private sector is made up of small to medium sized businesses, so when I say the private sector is more agile, this is what I'm referring to, not big monolithic companies. As long as there's not too much corruption or monopolisation then there will always be opportunities for smaller and more efficient companies to lower costs and improve efficiencies over all.

So what costs have smaller and more efficient companies lowered, exactly? What efficiencies have they improved?

I can think of dozens of things that only came about because the state threw its weight behind it (the internet, for one) or that only became useful and, yes, efficient, when they were nationalized (the railway network, phone networks, plumbing, etc) or when the companies behind them grew large.

 

 

[Blir]

Hey America look at what your cunt president is banging on about now.

 

]

[dingformung]

If he goes 100% totalitarian dictator, will the military be on his side?

[Blir]

Yeah of course the yanks love a bit of war. The whole country is primed for a dictatorship.