Summit Treestands
Why The Govt. CAN'T Fix Healthcare...
Community
Contributors to this thread:
K Cummings 28-Oct-17
TD 28-Oct-17
Gray Ghost 28-Oct-17
Tiger eye 28-Oct-17
Tiger eye 28-Oct-17
Gray Ghost 28-Oct-17
K Cummings 28-Oct-17
Gray Ghost 28-Oct-17
TD 28-Oct-17
Gray Ghost 28-Oct-17
K Cummings 28-Oct-17
HA/KS 28-Oct-17
Gray Ghost 29-Oct-17
K Cummings 29-Oct-17
Thumper 29-Oct-17
Gray Ghost 29-Oct-17
K Cummings 29-Oct-17
Gray Ghost 29-Oct-17
K Cummings 29-Oct-17
Gray Ghost 29-Oct-17
K Cummings 29-Oct-17
Gray Ghost 29-Oct-17
HA/KS 29-Oct-17
K Cummings 29-Oct-17
Gray Ghost 29-Oct-17
K Cummings 30-Oct-17
Gray Ghost 30-Oct-17
K Cummings 30-Oct-17
Gray Ghost 30-Oct-17
K Cummings 30-Oct-17
bigeasygator 30-Oct-17
Gray Ghost 30-Oct-17
K Cummings 30-Oct-17
Atheist 30-Oct-17
bigeasygator 30-Oct-17
gadan 30-Oct-17
K Cummings 30-Oct-17
bigeasygator 30-Oct-17
Gray Ghost 30-Oct-17
K Cummings 30-Oct-17
bigeasygator 30-Oct-17
K Cummings 30-Oct-17
bigeasygator 30-Oct-17
K Cummings 30-Oct-17
TD 30-Oct-17
Gray Ghost 30-Oct-17
From: K Cummings
28-Oct-17
Came across the following video while researching something else. It was so spot on, I thought it worthy of sharing.

Yes, it really IS that basic.

KPC

From: TD
28-Oct-17
makes sense. very well explained.

excep the "but it's a right!" mentality will take nothing from it.

From: Gray Ghost
28-Oct-17
So, do you think the "3rd party purchaser" concept applies to the military, as well, Kevin?

Matt

From: Tiger eye
28-Oct-17
It absolutely does. Govt contractors hose is every step of the way. Price and qualty

From: Tiger eye
28-Oct-17
It absolutely does. Govt contractors hose is every step of the way. Price and qualty

From: Gray Ghost
28-Oct-17
Tiger eye,

Then you'd prefer the military purchase their own stuff? By Kevin's simplistic video's definition, that would make the military a 2nd party purchaser, concerned only about quality but not price.

I guess the remaining alternative is the taxpayer's could purchase the stuff and form their own military. That would make them a first party purchaser, concerned about quality and price. Any idea how that would work out?

Matt

From: K Cummings
28-Oct-17
In my opinion, with the military the government would technically be a second party purchaser, but it has some traits of a first party purchaser because they are the users of what they purchase, and while the money is not "theirs" it is limited by budget constraints.

And yes, I would say they are more concerned about quality than price, as they should be...right up until the money runs out.

KPC

From: Gray Ghost
28-Oct-17
The money ran out years ago.

Matt

From: TD
28-Oct-17
A good deal of the military purchasing is by bid..... and most have quality standards to be met (military spec) and many times performance criteria and parameters attached to the bid.

An attempt however feeble at getting a good price and an attempt at quality control. And still wind up with $900 hammers from time to time.

1st party makes stupid purchases all the time as well. But the problem and results from a mistake are limited to the 1st party.

Obamacare simply drew arbitrary lines as to costs and quality that were essentially determined by the insurance companies, lawyers and social engineers..... no attempt at either cost nor quality.... just some screwed up sense of spreading equal misery.

From: Gray Ghost
28-Oct-17
So, is it safe to say second and third party purchases are necessary with respect to the military?

Matt

From: K Cummings
28-Oct-17
"So, is it safe to say second and third party purchases are necessary with respect to the military?"

It's the system we have but I don't know how "necessary" it is.

After all, some people estimate that roughly half of all US forces in Iraq and Afganistan are employed by PMC's (Private Military Contractors).

Who knows what the future will bring.

KPC

From: HA/KS
28-Oct-17
Then there is the fact that national defense is a constitutionally mandated function and health care is not.

From: Gray Ghost
29-Oct-17
How does a constitutional mandate change the concepts of 1st, 2nd, and 3rd party purchasers?

Matt

From: K Cummings
29-Oct-17
Matt:

It doesn't really. Nobody is making the argument that it is the most efficient method, but it is what it is.

Back to the original subject, is there something in the video that you disagree with?

From: Thumper
29-Oct-17
The video is spot on!

Picking out a medical insurance plan, it pays 80% of the cost for a medical procedure. Only problem is today the medical procedure now costs 15k, before obamacare the full cost was only 3k. So today under obamacare we're paying $1200 a month for insurance plus the full cost of a medical procedure.

Dad was ill and was covered 100% by his retirement plan, he was 99. In 2009 I'd get bills for 40k to 70k for one of his hospital stays, insurance paid them in full for 4k to 7k. In his final days those same bills from the hospitals were 150k to 225k and again the insurance paid them for 4k To 7k. The hospitals were hoping to file a lean on dad's estate by not submitting the inflated bills to his insurance co. Letter from the lawyer got their attention and they submitted them to his insurance.

Last year for a 4hr emergency room vist my medical bill was $26k. My insurance paid their share of the bill for $1.8k, my co-pay was $1.2k.

What I can't understand is why hospital administrators, pharmicudical company's, and politicians who voted for obamacare are not in federal prison under the Racketeer Influenced and Corrupt Organization Act.

From: Gray Ghost
29-Oct-17
"Back to the original subject, is there something in the video that you disagree with?"

I just think it's simple-minded. It states "All government purchases are 3rd party purchases", and concludes "There will always be waste in government spending". Yet, it focuses on health care which represents a measly 9% of the discretionary spending, while the military represents 54%.

The same people who claim the government always screws up anything they stick their nose into never question the military budget, or the waste that goes on within the military. I know suggesting military cuts isn't popular around here, but I don't think the "it is what it is" attitude is appropriate, either.

Matt

From: K Cummings
29-Oct-17
As Henry posted, "It is what it is" in terms of being constitutionally mandated. Is it the most efficient method? No. I don't think anyone would disagree with that, nor does it mean nobody every questions military spending. Heck, Trump himself has done it many times and has promised to renegotiate defense contractor contracts...much to the left's consternation.

But that in no way takes away from the premise of the video. If we know third party purchases tend to be the least efficient, why would we want to add health care to the list of them, expecting the government to fix it.

Groceries are too expensive too, but I sure as heck don't want the government "fixing" that.

KPC

From: Gray Ghost
29-Oct-17
I think, much like the military, it will always be necessary for our government to play some role in health care. The reality is, some folks will never be able to afford their own health care, yet they will need it at some point, inevitably. So, by your video's definition, a second or third party system will always be necessary to some degree.

Matt

From: K Cummings
29-Oct-17
"I think, much like the military, it will always be necessary for our government to play some role in health care."

Unlike the military, the operative word here would be "some."

Yes, the government has a role in helping those who simply cannot help themselves. However, for the vast majority, first party purchases and market forces should prevail.

KPC

From: Gray Ghost
29-Oct-17
I'm glad we agree on that.

So, the real issue isn't whether or not the government should play a role in health care, but rather to what degree.

Matt

From: K Cummings
29-Oct-17
To my knowledge, nobody has ever disagreed with that.

The "real issue," at least in terms of why I started this thread, is realizing that the problems with healthcare cannot be fixed by government. We can only do all we can to limit their negative impact on the system as a whole.

Medicare, Medicaid and the VA are horrendous examples of inefficiency, corruption, and substandard care. Why would we want to add the entire system to that list.

KPC

From: Gray Ghost
29-Oct-17
"Why would we want to add the entire system to that list."

To my knowledge, nobody ever said we should.

To that point, however, your video suggests that "if 300 million people were free to buy their own health insurance", quality would go up and cost would go down. Since that's roughly the entire population of the US, the video implies the government should play no role in health care. I say that's simple-minded unrealistic thinking.

Matt

From: HA/KS
29-Oct-17
"Yes, the government has a role in helping those who simply cannot help themselves."

"To my knowledge, nobody has ever disagreed with that."

That is where the problem begins. Individuals have the obligation to help people in need. As soon as even a small portion of that obligation is pawned off on "the government" we are headed toward a socialism that has been demonstrated time and time again to work against the good of the majority of the citizens.

Put me down as one who disagrees with that and has stated so multiple times on these pages.

The founders never intended the federal government to take from one citizen to give to another. It could be argued that the states were left with the power or option to do so, but never the federal government.

From: K Cummings
29-Oct-17
""Why would we want to add the entire system to that list."

"To my knowledge, nobody ever said we should."

Eau contraire. There is a whole host of liberals that would give their left arm for single payer health care system, and a whole host of others (including myself) that think that would be a disaster.

KPC

From: Gray Ghost
29-Oct-17
Kevin,

I meant nobody *here* has implied we should go to a single payer system. At least nobody with a brain, which excludes the trolls.

Matt

From: K Cummings
30-Oct-17
"The founders never intended the federal government to take from one citizen to give to another. It could be argued that the states were left with the power or option to do so, but never the federal government."

Good points Henry.

It could be argued that the Constitution does provide for such things under the "general welfare" clause but it could surely be argued the other way too.

I still maintain that the video is spot on. Some might call it "simplistic" but I maintain that simple is best when it comes to understanding concepts such as these. The government is GREAT at making things complicated, and therefore rife with inefficiency, waste, and corruption.

At the end of the day, if the people buying a product are neither the people paying for or consuming the product, you've got trouble.

KPC

From: Gray Ghost
30-Oct-17
Simplistic descriptions of the problem may make them easier to understand, but it doesn't solve them. That's were your video is lacking. Suggesting that allowing the entire US population to buy their own health insurance isn't a viable solution.

A viable solution would include local and state 2nd and 3rd party systems for those who can't afford their own health insurance, along with a more general free market solution for the rest of us. But then, you'd still have a large portion of our society who wouldn't buy health insurance even though they can afford it. That's were the 1st party purchaser system breaks down.

Matt

From: K Cummings
30-Oct-17
GG:

Notice that the title of the video was "Government Can't Fix Healthcare" not "How We Can Fix Health Care."

The video was not about solutions per se, it was simply an illustration about why we should not look to the government to "fix" health care. Until we understand why the gov't can't fix it, we can't move toward something that can.

KPC

From: Gray Ghost
30-Oct-17
Kevin,

"Government Can't Fix Healthcare" is a fairly simple conclusion for most of us. The solution remains a much more complex matter.

I'm not saying your video wasn't useful. I'm sure it confirmed the beliefs of many. I'd just prefer to see a video that outlines a viable solution.

Matt

From: K Cummings
30-Oct-17
I agree Matt, but "simple" concepts are quite often the most difficult for people to understand.

KPC

From: bigeasygator
30-Oct-17
Enjoyed reading the back and forth between KPC and GG. I think I'm very much in line with your thinking GG when it comes to what healthcare in this country...a combination of a free market system plus government support for those in need. I also think that if we're going to legislate a minimum amount of care as a right for everyone in this country, then "everyone" should have to pay.

That said, I got to thinking more about 2nd and 3rd party purchases and I think a key piece is being left out of the equation. Incentives. I don't believe necessarily that all 3rd part purchases are more inefficient/wasteful than 1st party purchases.

I think about how I spend my company's money. I am probably more efficient with it than I am with my own money quite honestly. I'm incentivized to be. My work performance is judged on how I manage my company's money and it factors into how I am paid (and essentially my ongoing employment). Its important to understand incentives when discussing the nature of purchases/spending. There are also other dimensions when considering 2nd and 3rd party purchases that might make them more optimal, like time and knowledge. We often trust others to make purchases for us because they have the time to do so or expertise in an area that we don't have (and are not willing or able to get).

Also please don't confuse these statements as a vote of confidence in our government's ability to fix things. I just wanted to bring those points up around the nature of 1st, 2nd, and 3rd party choices. I think there are benefits to 2nd and 3rd party purchases that are largely ignored in the video.

From: Gray Ghost
30-Oct-17
I agree, BEG. Not all 2nd and 3rd party purchases are wasteful. As a contract business owner, I often spend my clients money on goods and services for them. My ability to purchase quality at a fair price for them is a direct reflection on the success and profitability of my business.

Matt

From: K Cummings
30-Oct-17
"I think about how I spend my company's money. I am probably more efficient with it than I am with my own money quite honestly. I'm incentivized to be."

"As a contract business owner, I often spend my clients money on goods and services for them. My ability to purchase quality at a fair price for them is a direct reflection on the success and profitability of my business."

With all due respect, you are both conflating private enterprise and government. You both have a personal stake or "incentive" in making such purchases. In a very real sense, if you are directly held personally responsible for those purchases. Therefore, they are more like first party purchases than second or third.

Unlike the government where the people making the purchase decisions are seldom, if ever held accountable for those decisions. As a matter of fact, in a very perverse way, oftentimes those making the decisions in government are actually incentivized (buying votes) for making the wrong purchase decisions.

Apples - oranges...

KPC

From: Atheist
30-Oct-17
Single payer would solve many issues in healthcare. Would there be problems? Of course. The military bloat is a shining example. However we don’t immediately take away the govt role in the military. Yes it’s constitutionally mandated but caring for the domestic tranquility is also constitutional. How is it that every other civilized nation does it (single payer) and manage to lower the per person medical costs (far lower than that in the US) and yet Americans still protest against single payer. It’s mind boggling. One day even the most conservative of you or your family members will need a medical procedure and won’t be able to afford it without breaking your budget. It’s inevitable. What then? “Free Market will take care of it!” Nope. “ but it’s not the job of the government!” That won’t do the problem! Single payer will reduce our overall health costs as evidenced by every other civilized nation AND everyone gets healthcare. Which a the humane way to approach this topic. Not dollars and cents.

From: bigeasygator
30-Oct-17
With all due respect, it's pretty clear what the difference between 1st, 2nd, and 3rd party purchases are and they are entirely independent of the private/public nature of the enterprise.

When I'm using someone's money (in my case my shareholders) to purchase things I will never personally use (in my case I fund R&D for oil and gas exploration and production in my current role) I am a third party purchaser. The point of the video was that the government can never fix healthcare because it is a third party purchaser and all third party purchases are bad when compared to first party purchases. I think there are plenty of times where 2nd and 3rd party purchases provide much more economic utility than 1st party purchases. Furthermore, you kind of reinforced my point. It's not the nature of purchases but the incentive of the purchaser that matters.

From: gadan
30-Oct-17
KPC, You couldn't be more correct! One is never more careful than when spending their own money and the converse is true.

From: K Cummings
30-Oct-17
"With all due respect, it's pretty clear what the difference between 1st, 2nd, and 3rd party purchases are and they are entirely independent of the private/public nature of the enterprise."

I disagree.

If you are personally "incentivized" to spend your company's money wisely, or as GG said there is a "direct reflection on the success and profitability of my business," you are in essence spending your own money. You are making a de facto first party purchase wherein if you succeed, you benefit personally. If you fail, the results are borne by you personally.

Therein lies the difference between private enterprise and government and why comparing their spending is like comparing apples and oranges.

Your livelihood directly depends on you spending other people's money wisely and efficiently. That is rarely the case with the government. As a matter of fact, the exact opposite is often the case.

KPC

From: bigeasygator
30-Oct-17
I don't disagree with what you're saying but you're arguing my point, not the point of the video.

The videos point is that third party purchases do not seek to maximize utility and because of the fact that government purchases are always third party they are inferior to first party purchases.

A more appropriate argument is that it is more important to look at the rationality and incentives of the purchaser, not the nature of the purchase. Plenty of first party purchases are suboptimal from a utility perspective to second and third party purchases. A travel agent, for example, can often get a lot more out of my money than I can when it comes to planning a trip than I can. That's because they have knowledge and connections I don't. I often pay more for certain services because I don't have the time to seek out the most economically optimal solution (I don't care about price or quality...I need something now). The best economic solution from a utility perspective does not rely entirely on the nature of the purchase -- that is what the video suggests. I don't ageee with that point.

From: Gray Ghost
30-Oct-17
Therein lies the difference between private enterprise and government and why comparing their spending is like comparing apples and oranges.

I will point out that the videos solution to wasteful government spending is private enterprise spending. Therefore it is also making the same "apples to oranges" comparison.

Matt

From: K Cummings
30-Oct-17
"The videos point is that third party purchases do not seek to maximize utility and because of the fact that government purchases are always third party they are inferior to first party purchases."

Correct. And I agree.

What you are missing is that the purchases that you and GG describe (and refer to as third party purchases) are not actually third party purchases at all. In my opinion, you are getting too hung up on nomenclature. (first second or third party payer).

Yes, you are spending someone else's money, but your money is also directly at risk. If you don't spend wisely, you lose your job or your profits. The results of your buying decisions are ultimately borne by you... positive or negative. Yes, a travel agent is technically spending your money, but if they don't bring a value to the table (make wise purchases) they will lose your business and it will cost them money.

The government has no such carrot or stick.

From: bigeasygator
30-Oct-17
They are exactly third party purchases. Again, the definition of a third party purchase is spending someone else's money (be it a taxpayer, a friend, a client, or a shareholders) on something you do not directly consume (be it a trip, food, a piece of equipment, or healthcare).

And a government official may not get re-elected if his constituents believe he wastes or misappropriates or is in favor of policies that misappropriate tax payer dollars. Or he may get reelected.

What you are saying is that there are no consequences associated with government waste and that's not always the case, just like there are not always consequences associated with waste of third party purchasers in the private sector. Sometimes there are, sometimes there aren't.

From: K Cummings
30-Oct-17
I also said "conflating" in an earlier post Matt.

"With all due respect, you are both conflating private enterprise and government."

Conflating suggests they are the same and is what you and BEG were attempting to do. Comparing them illustrates how they are different and what I was attempting to do.

Ultimately, the people that stand to gain or lose should as often as possible be the ones making the decisions. If you have no skin in the game, what do you care? It's akin to people who pay no taxes, voting to raise the tax rates of those that do. Why would they care, and besides, they just might benefit from it.

Government is a perverse and incestuous system where the people spending the money are often not in any way responsible for the purchases. So much so, that they often benefit from making the wrong decisions, and sometimes even go so far as to exempt themselves from them.

KPC

From: bigeasygator
30-Oct-17
I don't disagree with any of that necessarily and, again, you are arguing my point. The point of the video was that a first party purchaser transaction is always more optimal from a perspective of economic utility than second or third party purchaser transactions and extends this logic to government involvement in healthcare. The logic being that there is no incentive in a second or third party transaction to deliver an economically optimal solution (it's not my money and I'm not using the product so what do I care). Again, I don't agree with the video's logic, even if I do largely agree with the end it is arguing for.

There are incentives to deliver economically optimal solutions (yes, even by the government at times) from a price/quality perspective in a second or third party transaction. Sometimes these transactions deliver more economic utility than a first party transaction (yes, even by the government at times) would.

Often times people are incentivized to make suboptimal economic decisions (under any transactional system, be it first party or third, be it private or public enterprise).

Incentives are far more important to me than how a transaction is carried out.

From: K Cummings
30-Oct-17
Ultimately, the video was not about whether or not the government can make some wise purchases. It was about why the government can't be expected to "fix" healthcare. The examples contained within it were intended to illustrate that end.

To that end, I totally agree with it's premise.

KPC

From: TD
30-Oct-17
In government often there is a disincentive to be more efficient or save money. If they don't use the allotted budget their budget is reduced next time around. I've heard and seen it over and over. Same with public sector unions, (unions in general) if they become more efficient staff may be reduced. Efficiency is even sabotaged.

The resistance to "incentivize" is strong in those Obi Wan. Profit in government is not a driving force..... "greed" only exists on an individual or possibly inside group level...... not any performance level. It's become a culture of it's own. Many cases the cuts just need to be made and tell them to make it work. prioritize. Even then the first cuts often are at the floor level and not upstairs. I recall a while back the Maui TSA were told to cut back......so instantly almost all cuts were on the floor and few if any supervisors cut. This slowed the flow at checkpoint to a crawl..... passengers and airlines were up in arms. It was meant to go that way by the supervisors as a "message" to management, clearly stated so. There was soon a big shake up but the main point was that culture that had grown in a relatively short time.

Private sector having the goal and metrics of profit..... the incentives as well as the freedom and culture are much more dynamic I guess you could say. In many ways public sector is always going to have different issues as to efficiency.

But the effort must still be there. Effort at some kind of reform and improvement must be there or things flow downhill incredibly fast. See the VA, IRS, EPA, etc.

From: Gray Ghost
30-Oct-17
I've long advocated that political jobs and compensation should be tied to performance. I think that would solve a lot of issues.

Matt

  • Sitka Gear