Soft privatization

[Enrique Diaz-Alvarez]

Marta Russell wrote:
> 
> Enrique Diaz-Alvarez wrote:
> 
> > Mathew Forstater wrote:
> > >
> > >  Public sector activity should not be judged by the same criteria as private sector activity.
> >
> > Of course not. Nobody is saying it should. But the fact is that
> > resources _are_ limited, even for the public sector. All universal
> > health care systems, for example, have to make tough allocation
> > decisions, which means that some people who need operations get them
> > right away, others have to wait for years, and others will never get
> > them. An efficient system, as I see it, does this in a way that
> > maximizes the general health and well being of the population for a
> > given amount of expenditure.
> >
> 
> Consider that the rich can buy however much health care they want in any of these countries so to
> argue that people who are in a univeral system have to settle for less is accepting the vast
> maldistribution(inequality) of wealth that exists today.

Consider also that the reason universal
> health care is rationed is because the capitalists still control the means of production for
> health care.  

That's true of the Canadian system, were the profit motive has only been
removed from health insurance, not health delivery. As a result, the
Canadian system is fairly inefficient, although not as much as the US
disaster. I think it consumes 12% of national income, the second highest
rate in the world.

In other socialized medicine systems, such as Spain's and the UK's (I
think), hospitals and clinics are built and run by the government.
Doctors are government employees, and budgets are allocated by
government bureaucrats. The profit motive is completely removed, and
these systems are vastly more efficienct, consuming about 6% of
respective national incomes and delivering equal or better access to
health care.

Spain has a small private health care sector, but, save for very
specific clinics and specialities, it is generally acknowledged to be no
better, and in some respects worse, than the public one. It is there
mostly to satisfy those who'd pay not to share a hospital room with the
unwashed. It's OK with me.

Still, as efficient as those systems are, there are only so many CAT
scanners, and somebody hasto decide who gets the CAT right away, who
goes on the waiting list, and who doesn't get it at all. If that person
is an expert doctor on a fixed salary with no financial incentives
either way, I am satisfied.


> In the U.S. HMOs still make profits from Medicare and Medicaid enrollees ( I think
> HMOS pocket more money in percentage than even private health insurers, though don't quote me).
> And consider that less money is available for health care because private insurance still exists
> and more health care would be possible if the corporate middle man was not getting a cut.
> 

I agree.


> I think that it is dangerous to start making health care judgements based on quality of life -

Perhaps it is dangerous, but I see no alternative. How else do we make
those judgements?


> that is what you are really talking about when you talk about rationing. Who decides?  Who loses
> in such a Social Darwinist set up? The poor, the disabled, that's who.
> 

Not necessarily.

Cheers,
-- 
Enrique Diaz-Alvarez            Office # (607) 255 5034	
Electrical Engineering          Home #   (607) 758 8962
112 Phillips Hall               Fax #    (607) 255 4565
Cornell University              mailto:enrique at ee.cornell.edu
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