Quote of the Week

by publius

Via Amanda Marcotte, here's your quote of the week.  It's from Arthur Laffer, of Laffer Curve fame:

If you like the Post Office and the Department of Motor Vehicles and you think they’re run well, just wait till you see Medicare, Medicaid and health care done by the government.

Comments

[russell]

D'OH!!!

[Uncle Kvetch]

That was a close call: I was all set to dive into my "Actually, the DMV in my state functions pretty damn well, thankyouverymuch!" screed, but something made me say "Hmmm, wait a minute..."

Just goes to show: He who leaps is lost.

[Gary Farber]

YM Medicare and Medicaid aren't run by pixies and elves?

[Linkmeister]

Gary, they're not. But their rules are all written on napkins. Shelves and shelves of napkins.

[John Thullen]

America's media kidneys have failed.

The impurities flood the system unfiltered.

[PaulW]

Actually, the Post Office is run rather well. The cost of postage is lower than in most other nations, isn't it? And delivery is roughly 1-2 days in-state, 2-4 days out-of-state. A letter sent to Vancouver gets there within a week, well within deadline needs. And we've always had a national-run postal service, haven't we?

And the last time I went to my DMV office to update my car tag, I was in and out within 10 minutes, everything paid for and done. Last time I went for an updated driver's license, I waited about 20 minutes. There wasn't a long line ahead of me either time.

I honestly can't recall anyone bitching to me about the post office or the DMV. I've had people bitch about getting caught in paperwork nightmares with HMOs, billing issues, coverage denials, what have you. And you're saying government is gonna be worse?

[John Miller]

Well, the DMV does take some pretty crappy photographs.

[Warren Terra]

PaulW, everything you say is true, and indeed righteous - but you do rather seem to have missed the elephant in the room that is Laffer's inanity, and leapt into the pit Uncle Kvetch just barely avoided.

[Hogan]

Seriously. Complaints about the DMV are the political economy equivalent of mother-in-law jokes.

[Mari]

It's as I always thought: Medicare is run by aliens, not the government. That accounts for the general satisfaction level.

[Redstocking Grandma]

My belief is human progress is based entirely on how much New York State's DMV has improved over the last 15 years.

[Matt Osborne]

Either Laffer is an out-of-touch Cessna conservative who hasn't used the DMV or the post office in far too long, or he's playing stupid deliberately.

Is he a tool, or just naive? Publius reports, YOU decide.

[Linkmeister]

I'm sure the think tank checks get to Laffer via the Postal Service, so he shouldn't argue that it's lousily run.

[cleek]

the only time i had trouble with a DMV is when i first moved to NC and had to take the driver's quiz. the woman gave me the quiz and a pencil, told me to drop it at the Quizmaster's table when i finished. then she went on her lunch break. the quiz took 3 minutes (like 10 questions, multiple choice).

nobody would reach onto her desk and give me my NYS driver's license so i could leave. and they wouldn't let me reach over and grab it myself.

f'in idiots.

[PaulW]

Warren Terra, I am aware of all Laffer traditions (write overly simplified things on napkins and pretend they have as much intellectual heft and researched veracity as a 300-page dissertation from Rollins College School of Business). I'm just saying what needs to be said. And I like jumping into pits, because sometimes you must face the lions. The trick is to be unafraid.

It would be helpful if one of the Obsidian Wings overlords would repost any the nice things they've said about the Laffer Curve.

And Linkmeister, in this day of direct deposit I don't think Laffer gets his think tank payoffs through the mail. Large boxes of unmarked fifties and hundreds just don't fit into the USPS slots. :/

[David in NYC]

Seriously, has anyone ever been more aptly named than Arthur LAFFER?!

Even spells it like a true moran.

[Linkmeister]

PaulW, you might be right. Laffer surely approves of gigantic corporate bureaucracies, especially their payroll and payables departments.

[Gary Farber]

"I'm sure the think tank checks get to Laffer via the Postal Service, so he shouldn't argue that it's lousily run."

I'd think they might be up to direct deposit by now, actually.

[Barry]

Here's a serious question - has Laffer *ever* said anything worth listening to?

[please don't bring up the Laffer Curve; I actually passed Calc I, and know about derivatives and such]

[Mark]

sigh. I am a Canadian who stumbled upon this. Once and for all people, in Canada the government DOESN'T run the heathcare system. It is NOT socialised medicine. The government just PAYS for it all. And yes, has influence via the ability to cut (or increase) funding.

[Gary Farber]

"Once and for all people, in Canada the government DOESN'T run the heathcare system."

That's nice, but you're the first person to mention Canada in this thread, so what the heck are you referring, and who do you think here isn't aware of this?

[Marty]

"I honestly can't recall anyone bitching to me about the post office or the DMV. I've had people bitch about getting caught in paperwork nightmares with HMOs, billing issues, coverage denials, what have you. And you're saying government is gonna be worse?"

The great thing about Medicare is most people covered by it have very low expectations. They don't complain when denied a service because they know going in there are limited services. They don't complain when they have to do paperwork because they know the doctor has to have it done BEFORE he will provide the service. They are patient, waiting weeks for a doctor or therapist to confirm that Medicare will pay, something the average insured person would become angry about.

For those who think the average person can't manage their own healthcare, they should sit around a lunch table at a retirement community and pick up the tips and tricks exchanged there.

Yes, it will be worse. Perhaps not unmanageable but not as good.

[Marty]

"sigh. I am a Canadian who stumbled upon this. Once and for all people, in Canada the government DOESN'T run the heathcare system. It is NOT socialised medicine. The government just PAYS for it all. And yes, has influence via the ability to cut (or increase) funding."

I think the impact of the e-Health scandal and subsequent requirements of the Ontarion government to put everything out to bid belies the intent of this. The Canadian government doesn't run healthcare, the provinces do. It is still delivery by the government. Socialised is relative.

[Gary Farber]

"Yes, it will be worse. Perhaps not unmanageable but not as good."

I'm really sure it won't be worse for the 47 million uninsured.

[Gary Farber]

"The Canadian government doesn't run healthcare, the provinces do. It is still delivery by the government."

Wrong:

[...] The health care system in Canada is funded by a mix of public (70%) and private (30%) funding, with most services delivered by private (both for-profit and not-for-profit) providers.

It's not government-provided, government run, health care:

[...] Canada has a federally sponsored, publicly funded Medicare system, with most services provided by the private sector. Each province may opt out, though none currently do. Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate. Most family doctors receive a fee per visit.

[...]

The various levels of government pay for about 70% of Canadians' health care, although this number has decreased somewhat in recent years.

The government pays part of the costs, and the government doesn't run any of it, other than:

[...] The federal government directly administers health to groups such as the military, and inmates of federal prisons. They also provide some care to the Royal Canadian Mounted Police and veterans, but these groups mostly use the public system. Prior to 1966, Veterans Affairs Canada had a large health care network, but this was merged into the general system with the creation of Medicare.

And also providing health care to the First Nations:

[...] First Nations. Native peoples are a federal responsibility and the federal government guarantees complete coverage of their health needs.

Meanwhile:

[...] About 30% of Canadians' health care is paid for through the private sector. This mostly goes towards services not covered or only partially covered by Medicare, such as prescription drugs, dentistry and optometry. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.[15] There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.

The Canadian system is for the most part publicly funded, yet most of the services are provided by private enterprises. Most doctors do not receive an annual salary, but receive a fee per visit or service.

"Socialised is relative."

Socialism:

Socialism refers to any one of various theories of economic organization advocating state, public or common worker ownership and administration of the means of production and distribution of goods, and a society characterized by equal access to resources for all individuals with a more egalitarian method of compensation.

[...]

Economically, socialism denotes an economic system of state ownership and/or worker ownership of the means of production and distribution.

Where's the ownership of the means of production?

There are various subcategories of socialism, but all include public/governmental/worker ownership of the means of the production of the resource in question. You're not entitled to make up your own definition on this.

[Marty]

" You're not entitled to make up your own definition on this."

Thanks Gary, I missed this. I also know who provides my healthcare.

[Enlightened Layperson]

The big problem I see with anything like a public option, let alone a single payer in the US is that sooner or later it will fall into the hands of the Republicans, who will do their best to wreck it. That is their ultimate argument against any sort of social program these days. "Yes, but do you trust US to run it?"

[russell]

"Socialised is relative."

Is the problem here "socialized" vs "not socialized"? If so, IMO we're talking about a quibble.

The government, both here, in Canada, and in basically any other modern nation, is involved in the provision of health care to the population. In all or nearly all cases, so is the private sector.

So yeah, "socialized" is relative. So much so as to be beside the point, IMVHO.

The question is what is going to work, and what is not.

What we have now doesn't work well. Or, rather, it works splendidly for some, pretty well for lots, and spectacularly badly for a significantly large number of others. Like, at least 15-20% of the population.

And the overall cost is head and shoulders more than in any similar place.

My personal political point of view affords me the luxury of responding to cries of "socialism" with "your point?". I just don't get what the issue is.

Health care isn't a consumer good. Or at least it ought not be considered one and treated as one. When people can't get it, they die.

So as far as I'm concerned, we should just look around and see what's going to work and do that. And by "work" I mean make a useful level of health care available to every freaking person in the United States of America.

The vanishingly small number of folks who want to go off the grid and hotfoot it for the territory ahead in order to escape the noxious tentacles of Big Gummint may feel free to do so. The rest of us just want to go to the damned doctor.

[Marty]

"So yeah, "socialized" is relative. So much so as to be beside the point, IMVHO."

My original point, thanks.

And I will refrain from the consumer good argument to say that, government can control the means of production without "owning" it, which is the case in Canada. All capital expenditure and budgeting is done by the government in a number of provinces.(ex: here ). They have great latitude for enforcing everything from acceptable protocol to acceptable outcomes to purchasing decisions. Once you control the the means of production, how you pay the employees is irrelevant.

[Eric Martin]

The VA is socialized medicine moreso than either Medicare or the Canadian system. It is completely government run.

It's also extremely well run, efficient and quite adept at keeping costs down.

[russell]

"All capital expenditure and budgeting is done by the government in a number of provinces.(ex: here ). They have great latitude for enforcing everything from acceptable protocol to acceptable outcomes to purchasing decisions."

And what is the result?

Is 15% of the population uninsured, and a significant additional percentage underinsured?

Do people find themselves in the situation of having to go to the ER every time they need even the most basic medical attention?

Do people die from preventable or readily treatable illnesses due to lack of access to care?

Assuming the scenario is as you describe, why is it *bad*?

[Marty]

"Assuming the scenario is as you describe, why is it *bad*?"

Where did I say that?

[Jesus m. Alvarez]

Actually, in NJ the Dept. of Motor Vehicles runs extremely well. I am never there more than 20 minutes, no matter what the issue is and their customer service is quite good. The service was vastly improved under Gov. McGrevy. And I've always been an admirer of the daily accomplishments of the Post Office. They move an incredible amount of pieces of mail without that much of a hassle and for a pretty reasonable amount of change.

And in the areas where the government runs healthcare, it does alright.

It's an argument advanced by people who don't care about the facts.

[Rob in CT]

I don't get picking on the Post Office at all. My experiences with the DMV have been mixed - some good, some bad (mostly pretty good, really). My experience with the USPS has been uniformly good.

[hairshirthedonist]

My personal political point of view affords me the luxury of responding to cries of "socialism" with "your point?". I just don't get what the issue is.

Um, russell, Joseph Stalin was really mean, and Nazism means nationalist socialism (at least it's an ethos). Oh, yeah, the French, too. Is that what you want here in the US?

[Jordan]

The fact of the matter is that those PO and DMV bashers are talking about personality (not personal) experience they perceived and not about the service and effectiveness for the price.
The experience at the DMV and PO is that you are greeted by blacks or fat, mostly both, or other races which doesn't make it a very pleasant experience (for repug racists)unlike encountering a pretty and extremely friendly person at any other private company.
Such first encounters brings a lot of animosity and anxiety during contacts which reflects on the approach and that takes the toll on the service worker which becomes even more defensive. To add on it there are very strict rules that apply equally to every customer at government offices while many obnoxious, threatening and forceful customers can influence the protocols at private firms.
It is about the personality experience that Repugs play at, not the effectiveness and quality of service.

[russell]

Jordan, I'm not sure quite what to make of your comment....

"Oh, yeah, the French, too. Is that what you want here in the US?"

Only if they bring their cheese with them.

Oh yeah, and Anouk Aimee.

[Alan Khalaf]

http://www.texaspolicy.com/legislativeupdates_single.php?report_id=2755

http://www.lafferhealthcarereport.org