I think you and I make simply different assumptions.

I don’t disagree with you on the profit motive issue you raised. This is a serious issue and we have to consider how it affects the delivery of services and how denials and rates are developed within the profit motive scheme.

There is a flip side to this which you haven’t discussed, which is the government’s black issue – budget motive. It is fair to say that the government has to operate within a budget. The government cannot afford to continue to print money to pay for the health needs of all people. These facts cannot be avoided. This creates rationing; which is why the government uses the consideration of “quality years” when determining who receives benefits. Hence my argument regarding the concept of a heart stent, if you could only afford to provide one more heart stent within your budgets and you have a 65 and an 85 year old man what will happen? I for one do not want the government making life altering decisions for me and my family based on budgets and statistical measures. Humanity means being more than just a mathematical equation.

The government has another cost issue not faced by private insurance, unions. The government option would create thousands of government jobs worked by union employees. The unions have shown themselves unwilling to forgo raises even this year when the private sector has been devastated and millions have lost their jobs or taken pay cuts. These people just don’t live in the real world. When Obama asked Afscme to forgo its mandatory 2% raise this year (Again we are not taking about cutting jobs or pay) the union said no and in fact said it wanted more than the 2%. This is a huge problem for any government program such as health care. This pay can only come from a cut in services or additional taxes. The result is more burden on the people via exploding budgets or fewer services.

By contrast, if a private company doesn’t make a profit, they can tell their employees that there will be no raises. Further, it is easier for the private company to terminate employees to even out costs. The government doesn’t do this, they simply are an incredibly expensive cost center particularly considering their incredibly rich benefit packages.

Regarding costs, I think if the government is in charge of health care it will reduce the amount of new drugs/methods used by the medical community. This is the case because the government’s choices have to be centered on helping the most people within the budget. Let’s assume we have two drugs, one is older and provides a 60% survival rate at price X and a second has an 82% survival rate but the price is X * 1.75. The government will always choose the first because they can treat many more people with the first choice though more will die.

Lastly, the concept of redress. If you dislike the decisions of a private health company you have either government regulation, arbitration or legal avenues to address those issues. Further, as part of the health care bill we could create a direct method for redress. If the government is in charge there committees, panels, etc, will be the word of last resort.

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