You’re making my point that we have no real way of comparing government to private industry.

Given that I just pointed at one obvious measure that could indeed be fairly simply cross-normalized (fraud prevention overhead cost + cost of fraud for a standardized fraud-related cost index) for direct comparison purposes of ACTUAL overhead efficiency, I would say your point was already rebutted.

I’d be very happy to have an effective health care insurance system, as opposed to the current system which has now forced me to waste thousands of dollars forming a corporation solely so I can get health insurance.

So? I sense not only a non sequitur (that the current system has open running sores does NOT mean that ANY replacement system or system “reform” will be an improvement) but also a veritable freighter-load of shaky assumptions.

For example, there’s an extremely effective health care “reform” that you would categorically prefer to the current system by your stated terms. Simply euthanize any patient whose life-threatening condition has odds of being cured through treatment of under 50%. This would free up enormous amounts of money for the treatment of others, no? After all, an enormous portion of current expenditures are in end-of-life care. (I seem to recall a European nation of the last century whose societal tab for care and treatment of the developmentally disabled was near zero. Very effective. Very efficient.)

Brings me back to a question I keep asking that very few are willing to offer an answer to. What exactly do we mean by “reform?” Because calling ANY change “reform” does not mean that the change will be either beneficial or desirable.

You’re making my point that we have no real way of comparing government to private industry. So conservative theology is just that, it is not reality-based.

By the way, the Marines actually are “efficient” by the standards of their class. They do more with less than the Army. (No dis to the Army from this Army brat.)

But I’ll take effective, Tully. I’d be very happy to have an effective health care insurance system, as opposed to the current system which has now forced me to waste thousands of dollars forming a corporation solely so I can get health insurance.

Call that inefficient, call it ineffective, or call it as my banker did yesterday, “retarded” it’s emblematic of the idiot jury-rigged system we have now.

If I were a Frenchman I wouldn’t be wasting my time and money like that. I’d be eating a charcuterie plate and a nice green salad and enjoying a glass of Sancerre. And in my fantasy there’d be a French mistress as well.

But I digress . . .

I’d be grateful for any example you can point to of me relying on theology of any kind, liberal or conservative. I would like to expunge such theological presuppositions from my thought process.

It should be noted over and over again that efficient is NOT the same as effective, or high quality. The Marines are both effective and high quality, but economically efficient? Heh. One suspects that Mike is having problems disinguishing effectiveness from efficiency. I’ll give him the National Park Service doing wonders with little, but note that the major reason for that efficiency is necessity — they must be efficient BECAUSE they have miniscule budgets for their tasks. So they concentrate on the very top priorities and let everything else slide. Efficient, but not effective.

Medicare is such a shining example of government efficiency that it’s got a mere $34 trillion in unfunded liabilities NOW. Their vaunted low overhead is also an open invitation to fraud, and sure enough Medicare is plagued by high levels of fraud. Medicare fraud is estimated at $68B a year, or roughly 17% of total Medicare spending. Anti-fraud spending and fraudulent claims are included in the overhead figures for insurers, but not for Medicare. So, love that Medicare efficiency! But hey, it’s all other people’s money, so that’s OK. Right?

The IRS? Concentrates on going after lower-level cheats with enough assets to pay but not enough to field fleets of lawyers. The VA? Better talk to some vets. Efficient, maybe. Like the park Service, not much choice. Effective and high quality? Not so much. The Secret Service? See above about confusing effectiveness with efficiency.

Do I believe businesses far excel government when it comes to innovation and making money? Absolutely. But their prime mission (their hypocratic oath, so to say) is shareholder’s return on investments. That mission can be achieved in part by denying care to those who desperately need it. How do businesses, who are held to quarterly growth projections, make these decisions without treating the people who need care as nothing more than expenditures?

I would make the same argument against privatizing our nation’s military.

See, here you go again to theology. You get uncomfortable when I try to move from general religious principles (government bad, business good) to engage on specifics. It’s like closely questioning a Catholic on transubstantiation. You can’t exactly explain why you believe what you believe. You cite no evidence. When I cite evidence to the contrary you dismiss it out of hand and again, offer no counter.

You have faith, not reason.

In fact governments (and it’s plural, inevitably) sometimes do well and sometimes do poorly. But it’s not the speed of light, it’s not immutable. Simply insisting that government does nothing well is contradicted by facts. Insisting that business is necessarily better is, likewise, contradicted by facts.

In fact a lot of business is lousy at what they do. A lot of the government works quite well.

I’ll desist from any further cherrypicking battles. It’s a pointless argument. I’ll even go ahead and concede your point that the government excels when it comes to things like collecting revenue from its citizens, killing people overseas, invading our privacy, and so on.

If you really think that “lots” of the government works well and “lots” of businesses work lousy,OK. Because sure, It’s true that lots of businesses are lousy. Usually, those are the ones that fail. Of course, if you can just raise taxes to stay afloat, failure is no worry.

Contrast with Enron, AIG, GM, Citibank, Bear Stearns, Lehman.

In fact a lot of business is lousy at what they do. A lot of the government works quite well.

More of it might work if Republicans didn’t do everything in their power to turn their theology into reality.

It’s almost impossible to convince Americans that the government is good at anything. It’s an article of religious faith for many Americans, a theology, indifferent to reason.

Actually, this opinion is limited to the American government, and is based on a wealth of experience. Speaking only for myself, it’snot an article of faith at all.I am open to objectiuve data that demonstrate otherwise.

But I aint holding my breath.

Honestly though, there are lots of things the american government is very good at. For example, borrowing money, and giving it away. Developing weapons. Making red tape. And so on.

“If America only stopped reinventing the wheel, and learned from Germany…”

America has a “not invented here” syndrome. If we didn’t invent it, it will never be good enough. If may eventually be our fatal flaw, but we take the concept of “greatest nation on earth” to be inviolable. And if we consider ourselves to be the greatest nation, yet hold our government is such low regard, you can imagine what we think of other nation’s governments.

It’s almost impossible to convince Americans that the government is good at anything. It’s an article of religious faith for many Americans, a theology, indifferent to reason.

Is our mistrust of the government higher than our mistrust of the insurance industry? Maybe we should look at Wall Street and extol the virtues of free capitalist competition? I came from a communist country, and I had this faith and trust in the inherent virtues and advantages of the capitalist system. I am not so sure what is left of that trust. If America only stopped reinventing the wheel, and learned from Germany (no need to scare us with how bad things are in Canada and Great Britain – in Germany things are NOT bad, and that is who we can try to learn from)! A debate about medical care is equivalent to a debate about education. Do we think that our government does a great job educating this nation? No. But do we propose to eliminate public schools and leave it to each individual to select a private option for their child? I personally don’t. I want people to have a government option along with a private one. Meanwhile, we will notice that unlike our insurance executives, principals at private schools do not get rewarded with multi-million dollar bonuses at the end of the year. Maybe because they know their “clients” have an option to go to a public system if they feel that the tuition price is exorbitant and spent to line the top execs pockets. And this is the way it should be with the insurance industry as well. I personally do not want to take on the fight for the insurance executives bottom lines under the guise of fighting against the government control.

The system has got to change. What we have right now does not work well. We invest a lot more than other industrialized nations, and the results we get are much more pathetic. I think the myth of American exceptionalism may make some of us believe that we are the best because we just are. But you need to look at the hard facts, and you will understand that bigger and more is not equivalent of better. In fact, did you know that taking cholesterol drugs or not taking them for a vast majority of the people is not going to make any difference whatsoever in their chance of having a heart attack? There are a few excellent books which I could recommend on the subject of what is wrong with our health care (except the obvious: 25% of all healt care dollars wasted to practice defensive medicine to protect the doctors from popential malpractice lawsuits – so in other words, we definitely need to cap what lawyers can make on suing doctors, and a considerable amount of the money flowing into medical care will be saved out right). Those books are “Overdosed America” and “Worried Sick”. Both are written by M.D.s, and both are based on solid research, not influenced by special interest groups.

There are countries where universal health care is not done right, notably, Canada and the US. And then there are countries where their population generally believe that they get excellent health care, and Germany is a good example. So why can’t we follow the example of Germany?

Oh, and by the way. We should absolutely keep the private health care as a parallel system so that people would have an option. And we should absolutely NOT cover health care of illegal immigrants. Yes, I do have a heart, etc, but if we start providing free health care to them, in a year’s time we will have not 12, but 35 million of them living here illegally. Unfortunately, this great land of ours it totally incapable of sealing its borders.

I would give them Advil, actually.

One of the annoying things about my time in Italy: standing in line to buy a dozen ibuprofen. I was reduced to loading my bags with giant bottles of OTC drugs when I’d fly back to Italy from the US. That’s right, I smuggled Advil and chlor-trimeton and and I don’t care who knows it.

On the flip side prescription drugs cost next to nothing.

Er, no. Unless you’re using a VERY broad definition of “government health care,” in which case we qualify as well.

Jason — the obvious observation is that people automatically equate “reform” with “better.” Would that it were so.

I know, it’s hellish over there. The poor French are basically living like animals, staggering around the arrondissements forced to scrounge for Band-Aids in the gutter, begging neosporin off tourists. I can see why uninsured people living in mobile homes in Arkansas would be terrified of having to live like Parisians. Shudder.