Nationalisation or Private?

[Twilight Hue]

Would you support nationalisation or privatisation of areas such as health, schools, prisons etc.? Why?

I'd be okay with national health and schools, with some provisions like parochial/charter schools for instance, but the enforcement arm of government should remain government, and not private for obvious reasons.

 

[Altfish]

My healthcare premiums from government mandated and subsidized healthcare are up 2000% since I started working. (That's about 20 years) In that time, the copayments have gone from $10 to $50.

My auto insurance is holding at $60/mo, but even when I had a sportier car it was $90/mo. It never went up and prices from competing vendors are similar. During that time my insurance provider has even added more perks including free rental cars, premium discounts, and roadside assistance at no additional cost.

The _only_ difference between these two industries is not what they do (insurance), but that one is privatized largely, and one is a government project. Which would you rather have?

I think as soon as the government gets involved you just get less service and pay more money, and history has born that out in my opinion.

I stand to be corrected BUT the difference has little to do with private v government run.
Car insurance is universal, so everyone has to have it, high risk, low risk, high earners, poor people.
Health care is a joke in the US with the GOP talking about 'freedom' to have it or not. Make healthcare compulsory for all and watch the premiums drop.

 

[Valjean]

Contrary to often regurgitated propaganda, it seems some services are most efficiently or fairly delivered by the government, rather than by private businesses.

For instance, private prisons in the US are the main lobbyists for tougher penalties for victimless crimes such as marijuana usage because they find it profitable to incarcerate marijuana users. Hence, the millions they spend each year lobbying state and federal governments for tough penalties. Before the rise of private prisons, we had a much lower incarceration rate in this country.

Private prisons have also been known to bribe judges to sentence people to them. These are not evils that are associated with state owned prisons.

Cost + profit will always be cheaper than cost alone. Wholesale is cheaper than retail.

What I find most alarming about the private prison contracts, though, is the inmate population provision.
These contracts stipulate that the prison population must be kept at a certain percentage of capacity, usually 90 - 98%, for the duration of the contract -- typically 20 years. If the census drops below the contracted percentage the state (taxpayers) has to make up the difference -- in effect, paying for empty cells.

The incentive this creates to keep prison populations high -- regardless of crime rates -- goes without saying.

 

[Valjean]

As an individualistic anarchist I don't trust the government to tie it's shoes. Historically, anything the government has been involved in has costed more or not kept the interests of the people at heart. Privatization means that consumer driven forces and competition have more of an effect on the quality of the services provided, and that the competition keeps the prices lower...

"The government," ideally, is We the People. Nonprofit agencies run, regulated and overseen by the public are efficient and inexpensive.
However, when corporate interests and their political proxies strategically undermine public institutions with funding cuts and appointment of incompetent management, or with managers frankly opposed to the agency's mission, you will get bad results -- which the advocates of privatization will point to as evidence that publicly run institutions are intrinsically incompetent. This has been a strategy for 30+ years. Recall Reagan's famous axiom about government being the problem, rather than solving it. This has become an entrenched meme among a large proportion of the population, primarily on the right, clearing a path for the wave of privatization/profitization that has undermined public services while increasing costs, over the past several decades.

My healthcare premiums from government mandated and subsidized healthcare are up 2000% since I started working. (That's about 20 years) In that time, the copayments have gone from $10 to $50.

That can be attributed to the increasing privatization of healthcare institutions, not to the government. Remember, insurance used to be not-for-profit.
It's the systematic undermining of public interest regulation that has allowed the medical, pharmaceutical and insurance industries the predatory license they exercise today.
The US "healthcare system" is a racket.

Note that no other developed country has healthcare or insurance costs even approaching those in the US, and it's not due to competition or privatization. It's due to government regulation or outright socialization.

My auto insurance is holding at $60/mo, but even when I had a sportier car it was $90/mo. It never went up and prices from competing vendors are similar. During that time my insurance provider has even added more perks including free rental cars, premium discounts, and roadside assistance at no additional cost.

The _only_ difference between these two industries is not what they do (insurance), but that one is privatized largely, and one is a government project. Which would you rather have?

I wonder how much lower your premiums would be if your car insurance were socialized.

I think as soon as the government gets involved you just get less service and pay more money, and history has born that out in my opinion.

I think you've been drinking the Reagan Cool-Aid.
The opposite is true. It's not government involvement that undermines efficiency and transparency, but privatization. Just look at the record.
The goal of private business is to maximize profits and minimize costs. The mission of public institutions is to serve the public good -- at cost.

 

[Valjean]

Private schools and healthcare are fine, as long as they exist as alongside public provision. Nationalisation I see as problematic though as it ends up with very large scale bureaucracies. Public provision should be much more decentralised to the municipal level.

I think the opposite is true. America's single-payer system (Medicare) has only 3% overhead. The bureaucracy is small.
US hospitals have massive billing and payment departments sorting out claims and negotiating with insurance companies. Canada's hospitals only need a couple of clerks in a small office.

 

[Jayhawker Soule]

Don't know, so I Voted Gulag.

I'd need to look at the evidence to know for sure about which is better in which situation and why. Resorting to ideological explanations or abstract principles is tempting but I'm not sure. I'm obviously biased towards state ownership in providing public services like health and education but I could support private ownership if I had reason to believe it would do a better job.

Good grief.

 

[YmirGF]

Private schools and healthcare are fine, as long as they exist as alongside public provision. Nationalisation I see as problematic though as it ends up with very large scale bureaucracies. Public provision should be much more decentralised to the municipal level.

Prisons need to be run by the state alone, as justice must be accountable to the people.

^This^

I have no problem with mixed schools and healthcare, as long as public options remain viable. Prisons, Fire Departments and policing should never be privatized.

 

[Mindmaster]

Note that no other developed country has healthcare or insurance costs even approaching those in the US, and it's not due to competition or privatization. It's due to government regulation or outright socialization.
I wonder how much lower your premiums would be if your car insurance were socialized.

Some of this is driven by market factors like the fact that Americans typically own cars, therefore they have more accidents than say a European country because we're "all on the road". Insurance premiums normally track with risk factors with profits built in, but in the auto industry since it is relatively competitive you know the margins are probably a lot less than health care. The problem is that healthcare is suffering from the same problem as government loans for school does - if you don't have to pay out of pocket they CAN and they WILL charge ANYTHING they want since the cost isn't reflected in the wallet immediately.

I think you've been drinking the Reagan Cool-Aid.
The opposite is true. It's not government involvement that undermines efficiency and transparency, but privatization. Just look at the record.
The goal of private business is to maximize profits and minimize costs. The mission of public institutions is to serve the public good -- at cost.

The mission for businesses is to appease the customers to gain those profits you speak of, and since they aren't burdened by regulation they can. Market forces drive their offerings, and because of that you often get better service for a lower price.

Here's what privatization of something like healthcare would give you:

1) Reduction of costs as an option, since you are free to have or NOT have the care. Thus things become priced on the value they provide.

2) Higher quality premium options for care, since the top tier plans would have to compete for your money.

3) Lower system-wide health care costs because the medical providers will have to work with insurance companies to sweeten the pot and draw more customers in.

4) Quality of service at the pos (the medical office) will be more important because if you complain to your insurer and they drop that medical group they will lose business.

What you have now is basically a system where because of the subsidized system the sky is the limit for charges and if you don't like it well you are still mandated to participate. That means even the caregivers aren't focused on providing a quality level of care because they get the money whether they give you the Ritz or completely slack off. Single payer would be EVEN WORSE because now the money comes to the healthcare provider from a different customer - the government. Proof is in the pudding - Canada's health care system is imploding, and places like Denmark have wait lists for any serious care. It's because if the money doesn't show up in this system on time the hospital/clinics have to WAIT for the money to come in before you are seen - or they cannot afford to render service. It's simple as that...

The customer gets served, and in a socialized system the customer is the government not you. That means your interests are never even considered - how does that sound to you? It sounds like **** to me...

 

[Rival]

Some of this is driven by market factors like the fact that Americans typically own cars, therefore they have more accidents than say a European country because we're "all on the road".

Not sure where you're coming from. Most Brits own cars. And French. And, well, most others.

 

[Mindmaster]

Not sure where you're coming from. Most Brits own cars. And French. And, well, most others.

Probably comes down to the fact that you drive roller skates mostly over there...

 

[Augustus]

Here's what privatization of something like healthcare would give you:

1) Reduction of costs as an option, since you are free to have or NOT have the care. Thus things become priced on the value they provide.

2) Higher quality premium options for care, since the top tier plans would have to compete for your money.

3) Lower system-wide health care costs because the medical providers will have to work with insurance companies to sweeten the pot and draw more customers in.

4) Quality of service at the pos (the medical office) will be more important because if you complain to your insurer and they drop that medical group they will lose business.

The problem is that the healthcare industry and the insurers have competing goals.

The HC industry wants more customers (so more treatment and more overmedication), getting more expensive treatments and medications, staying in hospital and the treatment system longer.

People want the 'best' healthcare treatment possible and don't care what it costs as the insurance is paying and most people will outsource that decision about 'best' to the doctor. If you are paying for insurance, then there is a psychological desire to get your 'money's worth' too.

Where I live the medical industry is pretty laxly regulated. My doctor works for a major multinational healthcare provider and has told me she is instructed to prescribe more than necessary, always choose the most expensive options, run more tests than necessary and schedule follow up appointments even when not necessary. She also told me that most 'customers' would complain if she didn't give them any medicine.

I've got into numerous arguments in hospitals, etc. when they have tried to give me something I didn't need or were clearly doing things to rack up my bill. It is clear that medical decisions are being influenced by financial directives.

We are already overtreated and overmedicated, and from my experience free market healthcare only exacerbates this.