diulei said:
Well, I may not be as verbose as some of the opinions here, but I just think the insurance companies have behaved in a deplorable way. There have been well documented cases of this and I don't think I need to quote statistics. I think if there is a government sponsored option, it will force competition and the insurance companies will have no choice but to step their game up. Don't want the government option? Fine by me and I'm sure people would all agree.
Seems to me FedEx and UPS are doing with even with the US Postal Service. And that's really how I would hope things go down. For your average, non-specialized health care, most people will stick with the government (analogous to USPS). Need something specialized or just don't feel that's the way to go? You go the private route (aka FedEx and UPS) who can provide different, and sometimes better, options.
I'm going to use your analogy, because it ties in with no_vas's view of Medicare as the standard of government run health care.
The U.S. Postal service has a monopoly on letters. It is illegal for any other entity to handle letters... a federal crime. UPS and FedEx handle "packages", not letters. Even so, they are recent competitors to the USPS, only being in existence since 1919 and 1971 respectively. They compete by delivering "documents and packages" more quickly, but at a much higher cost, than the United States Postal Service. The reason for this is pretty simple, the USPS can count on it's monopoly as a steady source of income, so it can afford to keep it's prices lower than that of a fully private company and at whatever schedule they wish. If UPS or FedEx had a monopoly on junk mail delivery, I imagine that they could reduce prices for package delivery too, since any delivery costs would already be covered by the junk mail delivery costs. Without that monopoly, the private delivery service would have long ago pushed the USPS out of business.
They may eventually do so, unless the USPS manages to offset the speed advantage. Let's assume they find a way, but at slightly higher cost to the sender. Instead of raising prices, what if the Federal government informed the major fuel suppliers that they were only going to pay a set amount for the fuel, an amount that was 10% lower than cost, and passed laws that the fuel supplier must sell to them at those prices. What if they did the same with wages for their worker, 10% below prevailing wages across the spectrum of managers, carriers, sorters, janitors, etc.? How would those fuel suppliers make up the shortfall? By raising the prices they charge non-USPS entities perhaps? What about the workers? They can't get raises, so they either quit or take on outside work maybe?
This is what Medicare has done. They set caps on what they will pay for medications, procedures, hospital stays, and even doctor visits. The program enjoys the advances of the privately funded medical system without shouldering the burden of those funding costs. They can set limits on what they require patients to pay and those patients have no other choice. Any shortfalls in the budget are covered with tax dollars and they have an effective legal monopoly on patients over 65. Even so, they are highly dependent on the existing private system paying for the R&D that allows them to treat patients with the most effective care. It's not a symbiotic relationship, it's parasitic from top to bottom. However, it does have the advantage of having the true costs obfuscated by multiple layers of government taxation, mandated price fixing, and lower out-of-pocket costs.
I use the post office when I don't care how long it takes a package to get there, or if I need a legally binding proof of delivery. For anything else, it's UPS or FedEx because they do it better, faster, and cheaper than the government alternative.
