For those of you that don’t know, I am currently in the UK working on my postgraduate education. In my own (anecdotal and non-scientific) way, I am experiencing Universal “Government-Run” Healthcare firsthand and writing about it here.
Last night, my wife and I were parked a couple of roads down from our flat in order to use wifi internet - we’ve recently moved and it takes upwards of a month to get internet hooked up here. As I prepared to drive away, I noticed two women walking from their car to the corner of the street, where a body lay on the ground in a fetal position.
I rolled down my window and asked if everything was alright. The women said that this man (about 50 years old) had fallen and seemed to have broken his arm - he couldn’t move and his legs were in an awkward position.
“Do you think we should call an ambulance?” they asked me. I was shocked at this - I figured they had already called one. Why in the world would these women hesitate to call for an ambulance? Even if the man wasn’t injured, it was around 40° F and was raining. He obviously needed help. I dialed for an ambulance right away.
On the phone, they quickly obtained my location and gave me instructions to keep the man from moving, and to keep him on the ground - that an ambulance would arrive shortly. I, along with a 19 year old who had come upon the scene, waited in the dismal weather.
And we waited. And waited.
In the interim, the man kept reaching for his head and holding his left wrist - he appeared to be unable to move it. He was also drunk (probably why he fell over). He was muttering incoherently, repeatedly asking where he was and complaining of pain in his arm, stomach and knee.
After fourty minutes of waiting in shorts and a t-shirt in the cold weather, I called again. With as much civility as I could muster, I told the operator that I had been waiting fourty minutes now for an ambulance - and that there was a man who was clearly injured , out in the cold and rain, and he needed help. She apologised, saying that it was a “busy night” and that an ambulance would be with me shortly.
The Ambulance Arrives - And It’s Just The Beginning
After an hour of shivering out in the rain, an ambulance finally arrived. It went first to a pub down the road - one of the people assembled around the man had to run over and grab the paramedics and bring them to the street-corner.
Before even looking at the man, the lead paramedic slowly walked towards us and asked “who dialed for the ambulance?” I raised my hand. She then said, “right, I am going to beat you up.” I am not sure if she was joking, or if she was upset about something, but in the ensuing encounter, she made it very clear that she felt this was a big waste of her time.
She never touched the man. She calmly walked over and began to mock him - making fun of the fact that he was obviously drunk. She played games with him, asking him questions about what he was doing and where he was going - responding with sarcasm and cold, uncaring paternalism. She never looked at his knee or his wrist - didn’t look for concussion or any other injury associated with a fall.
He complained that he was having pain in his stomach. She replied that it was probably a hernia or something, and that he should go to the doctor first thing in the morning. But she “asked” several times - “you don’t really need an ambulance do you?”
Without checking out the man’s legs or any of his other injuries, the paramedics then stood him up to see if he could walk. He couldn’t. He was either too drunk or injured.
He then held up his wrist and began to complain. The paramedic swiftly pushed his hand down and said, “you’ll be alright, won’t you.” It was a statement, not a question. She then turned to me and the 19 year old and said, “you two can walk this man home, I’m sure he’ll be alright.”
And then they left -and we carried the man a half mile uphill to his apartment.
As we walked back, we all felt a little guilty calling for help. We had obviously been far to concerned for this drunk old man who was complaining of pain, and couldn’t get up. I now see why the women who first found him weren’t sure whether they should call the ambulance - it might very well have been better to leave him out in the cold, wet night - lying injured on the street-corner.
For more of my experiences with Universal Healthcare, read:
Three things to mention here.
(1) This is more of a tip than anything, but I’ve heard that if it gets mentioned that there could be a cardio-vascular problem (e.g. stroke, heart attack, or just ‘my chest hurts when I breath’), even if it really isn’t, it gets a higher priority.
(2) That is really horrible of the ambulance workers. They should seriously be reported–repeatedly.
(3) I can only account this (and the other happenings) to the differences between then NHS in England and Scotland (as Scotland tends to be more ’socialist’ than England). The North Bristol Trust scores rather poorly…and this kind of experience is unheard of here in Glasgow.
I’ve seen some horror stories about 911 responses here in the US too. This includes a case where a 911 operator hung up on a woman obviously being beaten telling her to call back when she is willing to give her focus to the 911 call, and another case where a 911 operator hung up on a caller who used profanity while describing that her father was on the ground unresponsive. Emergency response workers who respond in these ways ought to face hard jail time.
If I were Colin, I would at the very least file charges against the paramedic for the threat. Threatening to beat someone up is still illegal in the UK, isn’t it? Your real failing here wasn’t calling for help, it was calling for a government funded form of emergency transportation rather than calling a taxi to take him to a private hospital (black market if necessary, say in Canada). The latter is clearly the more effective way of getting care in a government run health care system.
That’s disgusting. Did you get the paramedic’s name or some kind of id number?
Gurr8 - I was literally too shocked to say anything. I was completely shell-shocked.
Chris - re: #1 - good to know for practical purposes. Sad to know that it comes down to lying, deceit in order to get speedier service.
Atanamis - I don’t think my complaint would fly. If I complain about my internet, I find that something happens right away - afterall, there is some weight behind my complaint _ I can switch companies. Quite frankly, a complain to the NHS is more along the lines of Dicken’s “please sir, may I have another” - it is a complaint-beg. I have no power against a monopoly and the monopoly knows it. My complaint ultimately amounts to begging.
My husband & I were recently visiting friends in the UK. One day as our host was driving us through a town in SE England, we noticed an elderly woman lying on her side in the middle of the street with a crowd of people around her. My host stopped the car and asked me to check on the woman. As a Registered Nurse who works in an Emergency Dept. in the U.S., I’m sure that he thought that I might be able to help her. After quickly determining that the woman was unresponsive, not breathing and had no pulse, I said that we would need to start CPR. Another bystander said that she knew CPR and could help. Someone else called 911 (999 in UK). So, we started administering CPR. In contrast to your story, the ambulance response was quick. However, the paramedics who arrived appeared less proficient than I might have anticipated, at least according to US standards. First, when the paramedic came to the side of the patient, I did not see a defibrillator. I asked if the crew had one, and she said that it was in the ambulance. I’m sure the look on my face (”So… go get it”) led to her comment, “We have to take her into the ambulance to use it.” Moreover, as a first responder, she was totally focused on the bleeding coming from the back of the woman’s head. I said, “Her head is the least of her problems; we need to get her heart going.” This paramedic had inserted an oral airway and had attached a bag/valve mask, but I repeatedly had to remind her to squeeze the bag to breathe for the patient. After they loaded the woman onto a scoop to take her into the ambulance, I turned over the compressions to the paramedic crew. However, again, I had to remind them to continue CPR during the transfer. For 20-30 more minutes we remained outside the closed ambulance, which never left the scene. In itself, such a long delay was not a good sign, but our host did have opportunity to extend some words of comfort to the elderly woman’s daughter and her obviously-anguished grandson before it was time to take our leave.
Atanamis & Colin, I never took you two to be ideological shills. This ideological fear of ‘big government’ and inferiority complex is silly, to say the least. People have rights (Colin, can’t you vote?), paramedics have responsibilities, etc. The fact that these are being disregarded or downplayed under some assumption that ‘big government will just ignore my pleas for help’ is shite. I expect such out of politicians, but not out of people I consider well-educated and experienced.
cchrisr, you are being intellectually dishonest if you don’t acknowledge that the only advantage government has at any task is the use of force. This is really the only useful definition of “government” to begin with. I expect such intellectual dishonesty from politicians, and sadly from you as well. Until you are willing to be intellectually honest about what government IS, it will be impossible to meaningfully discuss with you what government should DO (national security / community policing only, or that and more).
Government IS an organization which regulates the “legitimate” use of force
I have an ideological fear of any service that has to force me to accept it. In some rare cases I am willing to accept this use of force as acceptable (national security / funding police forces), and even in those case I would “opt in” if given the choice. Ideally, I’d rather see people GIVEN the choice, since I believe the vast majority would like to have protection from foreign powers and street thugs. In most cases, the someone using force to use their service seems like an admission that I wouldn’t accept it voluntarily.
Government welfare vs non-profit charities
If you could create a superior health care provider, you wouldn’t HAVE to force people to accept it. People would accept it because what you were offering was the best service possible for the price. The ONLY advantage government has over private charities is force. If they provide certain services better than any competitor, there is no need for the services to be provided by “government”. A private non-profit mail delivery service 100% identical to the US postal service with the exception that it could not prevent people from using other services or collect money by force might remain solvent. If that organization is “better”, whether because it is non-profit or because its administrators are appointed by the US Congress, they would be able to sell their service entirely on the basis of their merit and not need a mandated monopoly.
Healthcare and the use of force
I’m fundamentally a utilitarian politically. If I thought national healthcare would work well, I’d probably support it. The thing is though that monopolies imposed by force are rarely run for the best interest of the consumers. This tendency is seen in any country that allows monopolies to be enforced against the will of the consumer. Any time you make it HARDER for someone to change service providers by force (legal restrictions), you increase the potential for abuse. That potential might not be realized immediately, but increasing the potential abuse for no real gain is stupid. The Canadian system (where private providers are banned) is outright immoral. People have a right to contract for medical help from whomever they chose on whatever terms they chose. To restrict this right in any way is immoral.
Non-governmental universal health care
That said, I would be perfectly fine with creating a non-profit health organization that operated based on donations and usage charges to provide coverage to its members. Take everything you like about “government healthcare”, and put it in this organization. Since it wouldn’t have the ABILITY to force people to use it or fund it, it would HAVE to provide better care less expensively to stay in business. It wouldn’t be ABLE to abuse its customers. You can even let elected officials have oversight over the organization if you want. The key is the inability to rely on an abuse of force to crush better alternatives or worse alternatives that patients prefer. Show me any legitimate way in which such an organization would be any worse than a true “government healthcare” program that does not involve the violation of someone’s constitutional rights.
Atanamis, how is that in any way related to what I posted? It’s fine to have one’s opinion on what is the best way to accomplish healthcare, but to say that all other ways are inherently bad (and that one’s own opinion is inherently good) is utter ideological bullshit. Secondly, while I can agree that government has the added bonus of being able to exert force, there are two things wrong with your objection of it: (1) capability (or existence) does not entail necessity and (2) there will always be government in some form or another that has the capability to exert force…even in an anarchist utopia, there will still be the desire to control, the Will to Power, etc. Even if one agrees with your assessment there, so what are you going to do with it? Just sitting back and crying foul doesn’t work.
Worldviews that ignore “logic”
Are you suggesting that this opinion is inherently good, and that those who disagree with it are inherently bad. Doesn’t that make your position ideological bullshit? I take it that logical consistency isn’t very important to you? That would explain many of our disagreements. I tend to expect a person to make sense, while you are fine making statements that are inherently self-contradicting.
The alternative
Clearly you didn’t read past the second paragraph. (Understandable, it was a long post with lots of words, which I’m sure made it difficult for you to read. I’ll include pictures next time). “What you are going to do with it” is to make things that don’t NEED to use force separate from the force wielding organization. Instead of creating a “public option” that is part of the government, create a “private non-profit” that does the same thing, but without the potential to use force to inflict its will.
Let’s examine Colin’s story with the assumption of competing services. If he’d called a taxi and it took an hour, would he have waited the whole time, or would he have called ANOTHER taxi service instead? Even if he DID wait an hour, do you think he’d ever use that service again? If there were competing ambulance services, he’d be able to do the same with ambulances. Under a single payer system, choice is gone. This works fine so long as the only choice left is good, but without choice people have no way of knowing if it is good. Maybe it costs more to get better ambulance drivers. Does it make sense to get more drivers who are bad, or fewer that are good? Only the buyer of the service gets to make this decision, but only the user of the service gets to experience it. The further you separate the buyer from the user the more inefficiency will necessarily be created.
Potential for abuse vs actualized abuse
Sure, potential doesn’t mean it will be used, but we do have the example of Canada where buying alternative care to the “public option” was made illegal: “On June 9, 2005, the Supreme Court of Canada ruled in a case dating from 1997, in which a patient, along with his physician, sued Quebec after a year-long wait for hip-replacement surgery. In a decision highlighting the persistent problem of waiting lists in Canada (see graphs),2 the Court voted four to three to invalidate the long-standing prohibition on private insurance for services that are available under Quebec’s public health care plan.3.” This man was prevented by law from getting a hip replacement for over a year. I support the idea of universal health care, but I cannot support the use of force to make people use it or to fund it. Doing so allows the “universal health care” to IGNORE the people it is supposed to be helping. Will it? Maybe not. But it CAN. A “private” universal health care program that is paid based on the care given to patients CANNOT ignore its patients. Is our current program abusive and poorly managed? Absolutely. Does it make sense to replace it with a program that is MORE susceptible to abuse and mismanagement? I don’t think so.
“Government” (an organization that “legitimizes” force) will always exist
I agree. We LIVE in an anarchistic world where those with the muscle make the rules. One might not like those rules, but the answer is to change the rules rather than believe that somehow those with muscle won’t always make the rules. At least in our current system the people have some level of influence over what those rules are. To prevent abuse though, those rules ought to be as permissive as possible. The more control that any organization if given the more likely that power is to be abused at some point. US history has proven this as clearly as that of any other country. Cases where force is used to achieve a goal should always be kept as minimal as possible. Protection of person/property/liberty seems like a good restriction to me, especially combined with voluntary payment of taxes for national defense and policing.
You seem to be very thick-headed as you are very good at misinterpreting what is written. A point of view isn’t necessarily caught between the two axes you are playing with. A pluralist view can accept that there are multiple plausible answers, some better than others but none perfect. I think you’re mistaken your insistence that you are always correct with my supposed lack of logical consistency (not to mention anything of higher-order logics which make your statement sound like it is coming from a kid who took an intro to logic course in college).
Correct me if I’m wrong, but you seem to think that only government can use force and that it necessarily will. I want to bring that back to something else you’ve stated before: that modern government is a corporation. Taking those two statements, then, force is something that every corporation can exert. Government doesn’t have any special privilege and your ‘alternative’ isn’t any better.
Further, you seem to be confusing a single-payer system with the healthcare professionals. Changing the way the money gets to hospitals, ambulances, physicians, nurses, etc doesn’t change those parts of the system. Even in Canada, switching to private insurance will not change the way ambulance companies operate.
Making an absolute statement that no view is right or wrong is self contradicting because it IS an absolute statement. One can consistently state that they have seen no compelling evidence either way on a matter and don’t believe it exists, but to say that nothing is knowable is a claim that REQUIRES KNOWLEDGE.
You are wrong. What I AM saying is that government (by definition) claims exclusive right to determine what constitutes legitimate use of force. Any group which does NOT make this claim is not a government. Any group that DOES define when force can legitimately be used COULD abuse that force.
Correct, but corporations that are NOT governments are prohibited by governments from utilizing force outside of contractual agreements. IBM is not allowed to force me to work for them. I do not HAVE to buy food from McDonalds. If there WERE no government, these companies might be able to use force to make me do so. Since we DO have governments, the governments (in most countries) prevent these companies from forcing me to work for them or use their services.
They claim exclusive right to regulate the use of force, and finance most of their operations by mandatory collections of funds. This is absolutely a special privilege compared to private charities or corporations. If you believe it doesn’t make a difference whether “universal health care” is provided by government or a private charity, why do you not support my preference for a private charity that doesn’t have the ABILITY to abuse the use of force to harm patients?
See my link regarding the hip surgery. This was a Supreme Court case brought by a man and his doctor needed to allow a man to pay for the surgery in less time than the government wanted to wait. When you have a single payer, you have a single entity that defines who can get service and when they can get it. The doctor doesn’t choose, the patient doesn’t choose. Only the single payer has any power. This is a problem with current US healthcare plans as well, but a single payer program takes a failing system and makes it worse. Changing the payment system allows companies to provide better service for a higher price.
You can sit back and rely on the straw men and ad hominem attacks they taught you in philosophy, but we’re just going to keep going in circles as long as you do so. I know there are alternate worldviews that don’t respect logical consistency, and if that is where you’re coming from we probably aren’t going to get anywhere. That may classify me as “thick-headed” in your academic circles, but I still base most of my positions on “logic”, however naive that may seem to you.
Atanamis, you’re still playing in first-order analytics.
Perhaps the problem is that you are treating my statements of observations as propositional facts which must adhere to your sense of noncontradiction. Sorry, I live in the real world where parallel lines meet and contradictory statements can exist.
I think you’re arbitrarily limiting your critique to government. I’ll pick this up in the next piece. Secondly, you still haven’t been able to move from possibility to necessity. I COULD kill another human, but so far I haven’t. It’s a big leap to move from possibility to necessity, and you haven’t provided any cases or arguments to accept the possibility of abuse leads to the ultimate necessity of abuse. Again, I will pick this up after this.
Let me pick up my first ‘on hold’ from above…If government is ’simply’ a corporation, then this is just ’simple’ contractual obligations. Such a change in perspective makes it sound like you are complaining that the contract between the government corporation and (whoever) is unfair, even though they both willingly agreed to that contract.
Now, my second ‘on hold’…There is nothing in this to follow your claims of possible abuse and apply it to any corporation, government or not. There is nothing stopping McDonald’s from abusing its status, drive its competition into the ground, aggressively take over or bankrupt them, and create a virtual monopoly without creating a ‘real’ monopoly in its market. One could argue that Microsoft has done exactly this with the business office suite (Word, Excel, etc).
Again, your first statement sounds like you’re disagreeing with the contractual obligations of subscribing to the government’s services.
To answer the second statement (and question), however, I would say that you’re assuming I am against such. I would be perfectly fine with a private charity single-payer system…however, it’s unfeasible. There is nothing to guarantee it will remain a non-profit; there is nothing to guarantee it will be able to compete against the marketing from for-profit corporations, regardless of qualitative differences. There’s a reason why Wal-Mart has succeeded in producing cheaper, lower-quality items to the detriment of many local co-ops and mid-range shops.
I disagree (and agree) with this to an extent. I don’t see this happening in ’socialist’ Scotland. Operations may have wait times, but it has nothing to do with the NHS as the single-payer; it has everything to do with the local healthcare providers having limited resources and scheduling necessities. I experienced the exact same thing in the US for my nasal surgery: I had to wait 4 months for the surgery only because there was a cancellation and I was able to work my schedule around that. I would have otherwise waited an additional 3 months. I also know I had to schedule appointments in the US for myself and my wife 2-3 months in advance (especially the OB/GYN). None of that, however, should be construed as arguments against the entity that funded these (i.e. the insurance company or the NHS). However, I do agree with your sentiment (only slightly) because it appears that the entire healthcare system in Canada has administrative oversight by its government system. The same is not true in the UK.
Actually, it wasn’t something I learned in philosophy; I learned it from discussions with you.
Bullshit. (1) Your ‘logic’ is a simple propositional (i.e. first-order) logic and you refuse to try to even comprehend other modes of logic. Perhaps you still hold strictly to Euclidean geometry as well (where parallel lines never meet). (2) You base your ‘logic’ on Common Sense Realism, which is something that is hotly contested as it requires a particular set of assumptions that aren’t as ‘logical’ as one may think. But, of course, I’m the one being painted as the rhetorical troll. Look in the mirror…oh wait, perhaps that plank is too damn big.
That right there is why postmodernism is so dangerous… it produces nincompoops. Up is down, parallel is perpendicular, natural laws of time and space are whatever we say they are.
“I had to wait 4 months for the surgery only because there was a cancellation and I was able to work my schedule around that. I would have otherwise waited an additional 3 months. I also know I had to schedule appointments in the US for myself and my wife 2-3 months in advance (especially the OB/GYN).”
Where did you live? I’ve never seen anything close to that. I had oral surgery a couple years ago and had that scheduled probably about a month ahead of time (and it wasn’t something that had to happen immediately, as opposed to emergency surgery which I could have gotten a couple days later). My doctor is usually available a week out or less, and everyone I know personally has usually had similar experiences.
Darius, that was in Denver with an ENT specialist clinic (which was the only one within reasonable driving distance that my “good” insurance plan covered–which meant that I pay over $20k and they pay the rest). However, I think you’re reading my point there as a normative one, which I am not. I don’t think that is the norm, but that’s part of my point: using cases of extreme wait times does not constitute a norm. I had countless appointments with my doctors in the US which were within a week (and many within 48 hours)…but I also get that fairly regularly here in Scotland as well. And, to be fair, I had to schedule an appointment for my wife to see the podiatrist here 8 weeks in advance for an initial appointment. You attribute these observations as some kind of twisted ‘postmodern’ conception when no relation between the two exists. Parallel lines do meet in non-Euclidean geometry (look at longitudinal lines on a sphere). In other words, we don’t live in a world that necessarily conforms to our beliefs of ‘logical’ but that doesn’t mean there isn’t some kind of logic there (and Christians should be very keen to this point as they believing in a triune monotheism and a person who was fully God and fully man, who died and rose again, etc). If one wants to play the logic game, one must be aware of the consequences that it entails.
“However, I think you’re reading my point there as a normative one, which I am not. I don’t think that is the norm, but that’s part of my point: using cases of extreme wait times does not constitute a norm.”
Oh, I agree. Just because I’ve heard of two recent situations with paramedics where they were either untrained idiots or mean jerks doesn’t mean that all paramedics in the UK are like that or that EMTs in the US are all saints. What we have to look more closely at is the fact that socialism necessarily leads to an increase of the former and freedom allows more for the latter. Abuses abound within any system, since we are dealing with humans.
This is not a true statement. Socialism leads to less choice, it does not necessarily mean that the one remaining choice is wrong. Even in a true free market economy monopolies CAN form if one entity is just “better” at doing a task than any of their competitors. The fact that a government takes control of health care does not mean that the result will necessarily be bad. In fact, it could be good. The reason I don’t like the idea is not that government is inherently evil and will make healthcare bad, but rather because without choice people can’t leave a bad service if they want to. So long as the government care offer is good, forcing people to use it might not be a problem. The problem is that if it ever DOES become bad (and most services do when not experiencing competition for a long enough period), people can’t leave. IBM, Microsoft, and other large companies with near monopolies have found that they can only abuse their power for so long before everyone finds an alternative and they lose their monopoly. Government doesn’t face this problem because they can just make a law against competition (see the US postal services as an example of this).
A good modifier to my comment, Atanamis. Thanks.
Atanamis, I hear you talking about ‘choice’ time and again, yet I don’t see how that really affects what I’m saying or even any of the bills in congress.
Every European country I can think of has ‘choice’ in healthcare (even here in the UK with private companies like BUPA). Places like France are almost completely inundated with private healthcare companies that compete ‘free-market’ style for business. The only place (in the industrial West) I know of that does not allow any ‘choice’ seems to be Canada. The fact that government provides an option or even a baseline doesn’t affect the fact that there’s ‘choice’ in the insurance market. In places like the UK which have a government baseline healthcare market, private insurance tends to run cheaper (cheap enough so that a number of the companies that offer private insurance also pay the premium).
Even the most ’socialist’ bill in congress is rather tame in restricting ‘choice’ as they require every citizen and resident to have a plan. From the looks of their requirements, very few plans will be excluded from this list with the primary casualty being very high deductible catastrophic-only plans. Those that are looking for a public option are wanting to place that public option in the market as a way of fighting for choice (their sentiment not mine). To argue against a public option by way of ‘choice’, one would have to show that the public option would (1) beat the private plans at costs and (2) provide a good enough quality to effectualise a monopoly in the market…further the two most common arguments against the public option run against each other as one argues that the public option will be highly ineffective (with the implication being higher costs and lower quality) and the other argues that it will be very cheap (implying low costs and at least fair quality). The two cannot be used simultaneously if one wishes to remain ‘logical’. Further, neither works on its own merit (as the first would mean the public option being removed later for being a failure and the second would mean that the public option is too good for its market) but on reductive long-range speculation (i.e. government forcing the public option in the first case or government subsidising private companies in the second).
Further, what viable alternative is there to MS Office for desktop office software? OpenOffice? Google Docs? Apple’s office suite? None of those come even close to the market share that MS Office wields in the corporate environment. The first computer I have ever seen any of those on that wasn’t a personal computer (i.e. a computer that is managed by a corporate IT department) was here in the UK where OpenOffice is on its public access machines. Even 10 years ago, when there was still some competition from Lotus and Corel, MS Office was quickly becoming the dominant force in the market…and I don’t foresee that changing in the near future. Also, you cite the USPS as an example of government legislating against competition, but I have reservations with that. The non-competition only works for USPS mailboxes. I have seen enough companies use FedEx (and UPS) as their primary mail service to argue against the non-competition in the postal services (e.g. the Dish Networks HQ in Denver used FedEx for its monthly billing mailouts). Ironically, this is different in the UK where the Royal Mail service faces competition from other companies that do the sorting and collection of mail while RM handles the final delivery (in fact, that is one of the concerns in the current strike). Your fear of government always being corruptible shows a complete lack of faith in government itself, assuming that every candidate (even the ones you might vote for!) will do the worst possible thing in every situation. In that case, however, no action government does will be acceptable because the argument is against the very existence of government…and which leads me to suspect that you’d really rather have no government at all (and possibly no corporations either) and the discussion on healthcare will never be an actual discussion because we are working from two very different sets of beliefs regarding government itself.
I agree.
And I would be fine with this if the “public option” were set up as a private charity, with no unfair advantage over its competitors in the market. Government run “competitors” often get mandated advantages like the post office’s mandated monopoly of first class mail or tax advantages not available to other companies. This would allow them to undercut their competition not based on providing superior service, but because they play under different rules. All I am asking is that this kindly “public option” be created outside of the government umbrella to ensure that it play fairly with the competition.
Regular mail routes are BY LAW provided by the USPS only. I shouldn’t be surprised by your lack of basic fact checking anymore, but still am. Try Googling something like “USPS monopoly” next time:
http://www.usps.com/postallaw/_pdf/USPSUSOReport.pdf
It doesn’t matter. Microsoft cannot FORCE anyone to use Office. They cannot mandate that every US citizen pay them money every tax return. They can’t prevent me from buying a competing product if it meets my needs. My concern isn’t about monopolies, but about monopolies that rule by physical force. See my response to Darius. Monopolies aren’t the problem I’m addressing, monopolies that can force us to fund and use them using force (government mandates that will eventually result in imprisonment if ignored long enough) are.
Ironically, there are more than one way of providing route service. I love it how you ignore what I say and insert whatever you want. I am not questioning that the USPS routes and mailboxes are restricted to USPS usage. However, there are ways to deliver items without utilising those (isn’t it amazing how UPS, FedEx, DHL, etc somehow deliver things to our doors??). So take your ridiculous, snide comments about ‘fact checking’ someplace people might actually be intimidated by you.
Seriously, read an article or two about the subject, or even the linked report from the USPS to the US president about their legally guaranteed monopoly. This is a case where you are factually wrong, and your repeated refusal to do basic research (like clicking on a link FROM the USPS website) is astounding. Do facts mean nothing to you?
READ THE REPORT:
http://www.usps.com/postallaw/_pdf/USPSUSOReport.pdf
To answer, yes other companies can do special deliveries, but they are not allowed to run a regular first class mail route for letters. Notice how despite a US government service doing to same thing, most people still prefer to pay more for a third party to do it? Remove the USPS monopoly, and they will go out of business. Don’t believe me? READ THEIR OWN REPORT TO THE US PRESIDENT:
“The Postal Accountability and Enhancement Act of 2006 requires the Postal Regulatory Commission to submit a report to the President and Congress on universal postal service and the postal monopoly in December 2008.”
“The contours of the letter monopoly reside in a series of criminal and civil statutes, 18 U.S.C. 1693-1699 and 39 U.S.C. 601-606, known together as the PES.”
“Ultimately, however, reduction or elimination of the PES would render the Postal Service financially unsustainable and would severely undermine the public interest in efficient, frequent, accessible service in all areas at reasonable prices.”
Either the USPS is lying to the US President, or you’re full of crap. The REASON why they USPS claims to require this monopoly is that it is required to deliver mail to any address in the country for a flat rate. Of course, due to the requirement for people in rural areas to pick up their mail and the nearest post office, this claim is questionable. Either way, you are still full of crap.
You’re playing semantics here. I am not suggesting that FedEx, UPS, or any other courier service is running first class mail routes or that they utilise postage stamps. I am not contesting that at all. However, I am saying that these courier services do offer services that look and smell like the USPS services without utilising that name. I am speaking from my own personal experience of working with FedEx, in which I have seen businesses bring in regional bulk mailings on a monthly basis. I have processed through hundreds and thousands of these from both Dish Networks and DirecTV. All of these batch mailings are done through B2B deals utilising the FedEx Express 2Day rate (which tends to be greatly reduced for businesses that contract out the service–and the companies I mention did this). It is not listed as a ‘regular first class mail route’, it does not follow the USPS delivery route, but it still distributes letters to a large group of people. You can tell me that I’m full of crap, but unless you have something better than my own experience which can be corroborated by others with whom I have worked, I’m calling bullshit right back.
Again, I’m not contesting the USPS monopoly nor its viability. However, I am and have been suggesting that there are ways around this which are utilised and which do work in much the manner you suggest. Further, I have pointed out one case where the postal service has been partially deregulated is fueling its demise because the postal service ends up doing more of the work while a private business takes the money (anecdotal link). That is not an argument against a ‘completely free-market economy’ but against a hybrid of semi-privatised markets.
Dude, you know that FedEx is allowed to delivery priority items, but that it’s not legally allowed to offer a service that directly competes with first class mail delivery. Express 2Day delivery is not at all the same as first class mail. USPS has priority mail options too, but those are not the same thing as first class mail.
So it is seriously your contention that the US Postal Service is lying to the US President by claiming they are dependent on a monopoly mandated by law which you don’t believe actually exists, and that your experience working for a priority delivery service (which are specifically exempted by law) proves this?
A free market wouldn’t pay a private company to do less work for more money. The anecdotal link you posted even ADMITS that the Royal mail service is less efficient (more expensive) at the jobs being contracted out:
TNT is providing a more efficient service! If they are providing no value, how could Royal Mail be undercut? The Royal Mail could just match TNTs prices! It is apparently cheaper for BT to get TNT to pick up and sort their mail than to hire Royal Mail to do the exact same task. The problem in this scenario is that Royal Mail “mail carrier” department may be pricing its services poorly. This would be true whether the initial sorting was done by Royal Mail or by TNT. In fact, if the sorting were being done inefficiently by Royal Mail, there would be LESS money to pay “mail carrier” workers due to higher sorting costs.
Sorting Cost Carrier Cost = Total Cost
TNT Sorting Cost < Royal Mail Sorting Cost
TNT Sorting Cost Carrier Cost < Royal Mail Sorting Cost Carrier Cost
The carrier cost is THE SAME whether Royal Mail or TNT delivers it. If Royal Mail isn’t making enough money to pay mail carriers, that department needs to charge BOTH Royal Mail and TNT more for delivery. This may result in an increase in total price for Royal Mail, TNT, or both. One division cannot expect to be subsidized by another when they are being sold as piecemeal services. There is no magic here because one is “government” and the other is “private”. ANY bad department manager or poorly run company can make the mistake of underpricing services until unable to operate. In this case, “mail carrier” services appear under priced (or there are other inefficiencies in the department that need to be addressed).
This does demonstrate the problem of government monopolies though, since the mail carrier has no choice but to work for the Royal Mail or change fields (unless UK law is different than US law?). In a free market, a competing mail delivery service could offer more pay and better benefits to steal away the higher quality mail carriers. This is not possible when competition is banned by law. And while it is true that it might NOT happen with a free market either, it is at least possible. In a controlled market it is IMPOSSIBLE. Government services are dangerous because they have the ability to prevent the market from correcting for their mistakes.
The spelling is correct. It’s not the American spelling, but it is correct.
Atanamis, methinks you are trying to think of Royal Mail in terms of the USPS. The anecdotal author was clear that private companies are offering contracts to cover the initial sorting and inserts that into the Royal Mail’s stream which then re-sorts those pieces and delivers them according to their delivery obligations. For instance,
According to this person’s argument (and, in fact the Communicative Workers’ Union, which covers the postal carriers), these private companies are taking the more profitable aspects of the mail service and leaving the less profitable bits to the Royal Mail. As I mentioned in my last response, I take that as good evidence against semi-privatisation. I don’t necessarily agree with returning to a government-run model, as I think a true free market system may work (i.e. if TNT mail were to also deliver the letters instead of funneling them into the Royal Mail service). As a result of this, the Royal Mail is getting less funds (as apparently their level of funding is based on the amount of items that go from one end to the other, excluding those that come in from private companies) to do the same amount of work, if not more. And, yes, UK law is different from the US: anybody can deliver mail. In fact, every member of the EU was required to completely abolish that monopoly by 1 January 2009; the UK happened to do so earlier than the rest. However, that doesn’t stop private companies from collecting mail, sorting it, and handing it over to the Royal Mail for final delivery…which is what is happening.
Chrisr said:
“The spelling is correct. It’s not the American spelling, but it is correct.”
My usage was for “spelling in context”, indicating that while my posting used American spellings that my quote was using UK spelling. I apologize if it appeared I was correcting your usage.
Chrisr said:
“According to this person’s argument (and, in fact the Communicative Workers’ Union, which covers the postal carriers), these private companies are taking the more profitable aspects of the mail service and leaving the less profitable bits to the Royal Mail.”
Profit is DEFINED as the cost of providing a service subtracted from the price it is sold for. “Sorting” is only more profitable if the price the service is sold for is set significantly higher than the cost to sort the mail. If TNT can produce this service for a low cost, so should the Royal Mail. If the price set for “mail sorting” by the Royal Mail were lower than the price set by TNT, nobody would use TNT.
On the other side, TNT pays the Royal Mail to deliver the mail [or should be if they are not]. The total cost of the private mail service should be the cost that the Royal Mail charges to deliver PLUS the cost to sort. If the Royal Mail isn’t making enough money, they need to increase their prices charged to private mail sorters. If these prices are set by law (likely) they need to campaign to change this law.
The difficulty in setting prices to offset costs is PRECISELY the problem with most government run services. Either the price balloons because there are no competitors, or it stagnates because the service isn’t allowed to price its services fairly. The problem isn’t that TNT is allowed to sort, it is that the Royal Mail isn’t allowed to charge TNT fairly for delivery. (A “fair” price is one that covers the Royal Mail’s costs but is low enough to not cause TNT to create its own mail delivery service so they don’t have to use the Royal Mail.)
Atanamis,
I am accustomed to using ’sic’ to highlight an error (wiki).
The problem that I see with TNT (and this seems to be a fundamental part of the current postal strike) is that TNT is taking a larger portion of the money (as they are contracted with companies to provide the mail service–RM gets no income at all), does the cheaper portion of the mail service (collect and pre-sort), then gives it to Royal Mail for the more expensive part (the actual dispersal of the mail). For my argument, I will assume that the price RM charges for postage is an accurate price for their service, however that comes with the disclaimer that their profit comes from the combination of both collection and delivery as a way of balancing the cost of the back half with the income from the first half. If ‘competition’ is doing just the first half, taking the income, then passing the costly part to another part, then it’s not really competition. TNT doesn’t have mail carriers, and it doesn’t provide a full competitive service. They are, in effect, abusing the system. In this case, if TNT actually tried to compete with RM (and provide the full mail service), I don’t think anyone would have a problem. But I also don’t think TNT would be making a good profit…and I don’t think RM would be overworked. Ironically, this is the same thing I hear Scots say about the NHS in England (as it has also gone the way of ‘de-regulation’ that the mail service has).
If two services are provided separately, BOTH need to be profitable or exactly the abuse you described will happen. This is not a private/public abuse, but rather the market taking advantage of a poorly managed service provider. The Royal Mail isn’t being taken advantage of because it is a government service, but because it is mismanaged. If my ISP offers two services, internet connectivity and email, but expects to make all its profit from email, I will buy their cheap internet service and use free gmail. If they can’t pay their internet service staff, the problem is that they underpriced the internet service rather than that I “abused” the service by not paying for overpriced email as well. “Loss leaders” only work when people are BUYING your other services.
Those opposed to government services would suggest that mismanagement is common to government services, but there is no good reason why the Royal Mail can’t be better managed by the government. Literally all they would have to do is raise the price charged to private mail collectors like TNT. The end line worker doesn’t understand what is happening well enough to blame the right people, but whoever has the power to set the price for mail delivery is to blame for this problem. Government services tend to become inefficient when a large number of people or people without the appropriate skill set must agree to critical changes like pricing, but this can happen equally in a mismanaged private company.
We are seeing the same thing happening in the US at the moment regarding CEO salaries in the financial industry. When politics are used to set prices for services rather than a determination of what makes economic sense, the service provider suffers. If this happens in a private business the business runs out of money and disappears. When it happens with a government, currencies get inflated and national economies are wiped out. I don’t think there is anything wrong with a government providing a service that competes fairly in the market, but the dangers that can result from poor or malicious management are far greater.
Atanamis, the problem with the Royal Mail problem is that it was caused by legislation not by bad policy setting within the company. They cannot charge TNT anything because, for the purposes of mail carriage, TNT is not considered an external service (i.e. they don’t pay for ‘postage’ through RM).
Additionally, this highlights another response to our recent dialogue: there is just as much danger of a government service being abused as there is for government to abuse others. In other words, the claim that government can use force against any competition has (in my opinion) a major leak that needs to be fixed before it can be used as an argument against government-run services.
The claim is that government-run services are more likely to damage the economy. This is true whether government overprices its services and forces people to use them, or under-prices its services and runs the market into the ground. Let’s look at Royal Mail again. You mentioned that Royal Mail does NOT have a legally mandated monopoly (unlike the USPS). However, currently they are offering TNT a service for free that costs the Royal Mail money. No competing service can compete with “free”, so of course TNT doesn’t run its own mail delivery service. The Royal Mail kills competition by underpricing its services below cost.
In fact, Royal Mail can’t survive offering the service for free either, because eventually the workers will just quit working (strike). This happens because the legislators that manage Royal Mail don’t understand business, and is one reason why people like me oppose government services. (The other is potential for abuse.) If they DID understand business, they wouldn’t expect Royal Mail to subsidize TNT’s business without compensation. It still comes back to a mismanagement of Royal Mail, but by the legislators rather than the managers.