There are lots of examples of inefficient (if not outright fraudulent) charities. I don't see why you believe those are the exception or anomalies or don't pull down the average efficiency of charities to less than that of the Government.

Insurance is a great example where the private companies are extremely inefficient at delivering health care services (when I lived in the States I had to fill out 5-6 times more forms than I do in Canada for any given procedure). Edit: I believe earlier in the thread there was a link posted to the overhead of government provided health care compared to the overhead of private insurance companies - and the government won pretty handily.

I think our point is that charities are extremely far from providing the amount of service government is providing now. You hand wave that away with saying that if people paid less in taxes they'd give more to charity - enough to now provice an adequate social safety net.

This all seems to be based on your inherent beliefs with no evidence at all to support it.

I live in the United States. I used the word democracy because we always use that term in the U.S. even though it's wrong. I like the idea of a complete direct democracy, but that's a little while off. Right away I would prefer a more Euro-style representative democracy.

I believe that scam charities do pull down the overall average of charities re: efficiency. However I also believe that the scam charities are not in the group of large charities. Charaties file records so the way they spend resources can be tracked. Do you believe that their are scam charities in say, the largest 25% of charities?

Basically I would say that scam charities are tiny ones (based on their income as compared to all charities) because those are the only ones that can get away with it. Charities can be researched, and big ones get reputations. Do you think that goodwill or the salvation army or other ones of similar size are scam charities?

'Private' insurance has to comply with government regulations. The paperwork they do is to comply with government, not because they decided independent of government that this is all the way they want to do things... It's driven by government regulations.

Your belief is no more valid than mine, it's your belief, nothing more.

I don't believe this is true. The need for referral forms, pre-approval forms, etc. etc. are health insurance requirements. I'm open to be corrected though.

The thing is though I have the evidence that every single country with UHC provides similar service to the US with significantly less cost and significantly more government regulation. There's a chance that the demographic make up of the US is responsible but that seems extremely unlikely.

Here's the American Red Cross:

http://www.charitynavigator.org/inde...source=MFGCN40

They spend 3.8% of all revenue on fundraising expenses. Right away that's something that the Government doesn't have to do (morally - not sure that's good but still...).

Looking at the American Cancer Society:

http://www.charitynavigator.org/inde...source=MFGCN40

They spend 22% of all revenue on fundraising. These guys would have to be WAY more efficient than the government in every other area to come out ahead.

They're listed number 5 on the top 10 super-sized charities. http://www.charitynavigator.org/inde...tail&listid=24

Also the records of countries, or absence of, w/o UHC, nor gov't safety nets that are doing fantastic in providing adequate HC through charity.

But hey, it's just a 'belief...'

b

Good point. bkholdem, what's the country/time-period in history that best provided social services through private charity?

If you are going to make this argument you have to look at how much the government spends on tax enforcement and collection. There is also a small issue of how much would they spend fundraising if the government wasn't sucking up money.

And why doesn't gov't have to do that sir?

No idea. What was the % of people who had kids they couldn't afford before the new deal and what is the % of ppl who have kids they can't afford now?

The IRS budget is about $12 billion. It's a drop in the bucket compared to the amount of money spent on social services.

But I agree this isn't definitive proof of anything. But its something, and its evidence for my position. Where's anything even remotely similar for the position that private charities can more efficiently provide an adequate social safety net?

bkholdem - I'm not going to respond to any of your deflections until you post evidence supporting your position.

Medicare spends like 3% of total funds on administrative costs while private health insurance companies are 30%+. Admin costs tend to go down when you don't have to employ entire departments of people whose bonus is based on how many people's coverage they can find an excuse to drop while they're the fight of their life with bone cancer.

Just economic theory. There is an argument for a cost savings with a single payer system, but if you are going to take the worst possible system of charities, you should compare it ti a similarly bad system of UHC.

Of course in the fund raising are one would expect the government to be more efficient as charities have to convince people their money won't be wasted and the government just has to go take some more if they waste what they have. I will concede the point that a gun in hand is more efficient than a hat in hand when the goal is collecting money.

OK. Just keep in mind that does not make your belief that government is necessary to provide a safety net and that private charity could not or would not adequately do it....any more valid or anything other than that it is simply your belief.

Nor does it address the very probable, IMO, belief that the existance of the so called gov't safety net encouages people to not be as self sufficient as they can be.

I'm wondering if you know why people don't spend a week in the hospital following a toncilectomy like they used to when I was a kid? Or what the costs were for that kind of medical care compared to the costs for similar events today (I don't btw, but I think you get the point I am driving at).

lol

I really don't understand why this doesn't bother some people at all or make them suspect of the people and system that is behind such approaches.

Do you really believe that medicare and medicaid use less referral forms and pre-approval forms, etc?

I work in the mental health field so have some direct experience in meeting government regluations and they are whack. I saw a neuroligist a couple of years ago for some testing and we were chatting about the beaurocracy at my job. Joking, while also frustrated, I asked him if there was some medication that could be given to the beaurocrats that 'check' and 'inspect' records and so forth (to help treat the insanity of what they do). He shook his head and said no while acknowledging the insanity of the system in his facial expression. Then he said "Yes, I think it's called cyaniad".

Surgery procedures have improved dramatically since then. Especially the really common stuff like gallbladders/appendix.

Also as Im sure you obviously trying to point out, insurance companies/governments dont want to foot the bill

Well that's interesting. So I live in Canada, would you like to know what the premiums are for the average family of 3 up here? NOTHING.

Want to know what the out-of-pocket expenses are for hospital or doctor visits? NOTHING

Want to know how often people are denied coverage? NEVER

Now would someone please explain how exactly the US system is better, and for whom?

What I know is I pay over 30% of my gross income on healthcare...and I'm paying for the healthcare of people who make more than I do.

I would say for doctors because they get richer here, but it looks like doctors in Canada make comparable salaries to Americans (and in some cases Canada pays even better )

So I guess the American system is best for the CEOs of and people who invest in insurance companies and hospitals?

yeah but SEVENTY K THO, so quit whining

Food for thought:

http://medinnovationblog.blogspot.co...alth-care.html


Reasoning Behind Growing Health Care Bureaucracy

Preface: Everybody complains about the growing health care bureaucracy, but few analyze it and tell the reasons why it exists. That’s why we should be grateful to David Brooks, NYT columnist, for explaining what is going on.

Here are a few excerpts from a July 19 column ”The Technocracy Boom” on the bureaucratic mindset that has seized the imagination of the ruling party elite. The mindset is metastasizing in Washington. It is sucking the lifeblood and joy out of American business and health care enterprises. It says that those at the top can dictate what goes on at the bottom.

The italicized sentences are my doing. They explain the reasoning behind the new bureaucracies and the cultural backlash if they fail to do the job they are intended to do.

“In the second part of the period, Democrats were in control. They augmented the national security bureaucracy but spent the bulk of their energies expanding bureaucracies in domestic spheres."

"First, they passed a health care law. This law created 183 new agencies, commissions, panels and other bodies, according to an analysis by Robert E. Moffit of the Heritage Foundation. These include things like the Quality Assurance and Performance Improvement Program, an Interagency Pain Research Coordinating Committee and a Cures Acceleration Network Review Board."

"The purpose of the new apparatus was simple: to give government experts the power to analyze and rationalize the nation’s health care system. A team of experts on the newly created Independent Medicare Advisory Council was ordered to review and streamline Medicare. A team of experts within the Office of Personnel Management was directed to help set standards for insurance companies in the health care exchanges. Teams of experts serving on comparative effectiveness boards were told to survey data and determine which medical treatments work best and most efficiently."

"It’s a progressive era, based on the faith in government experts and their ability to use social science analysis to manage complex systems."

"This progressive era is being promulgated without much popular support. It’s being led by a large class of educated professionals, who have been trained to do technocratic analysis, who believe that more analysis and rule-writing is the solution to social breakdowns, and who have constructed ever-expanding networks of offices, schools and contracts."

"Already this effort is generating a fierce, almost culture-war-style backlash. It is generating a backlash among people who do not have faith in Washington, who do not have faith that trained experts have superior abilities to organize society, who do not believe national rules can successfully contend with the intricacies of local contexts and cultures."

"This progressive era amounts to a high-stakes test. If the country remains safe and the health care and financial reforms work, then we will have witnessed a life-altering event. We’ll have received powerful evidence that central regulations can successfully organize fast-moving information-age societies."

"If the reforms fail — if they kick off devastating unintended consequences or saddle the country with a maze of sclerotic regulations — then the popular backlash will be ferocious. Large sectors of the population will feel as if they were subjected to a doomed experiment they did not consent to. They will feel as if their country has been hijacked by a self-serving professional class mostly interested in providing for themselves."

'If that backlash gains strength, well, what’s the 21st-century version of the guillotine? “

Interesting stat's compared to Canada's healthcare system:


http://www.riskmanagementmonitor.com...lion-per-year/

Inefficient Health Care Bureaucracy Costs Physicians $27 Billion Per Year
by Jared Wade on September 28, 2011 · 1 comment

Everyone knows that the U.S. health care system is inefficient. This hurts both the nation and the employers that offer coverage to their workers. But a new study by researchers at Cornell University and the University of Toronto claims that the average U.S. physician pays $61,000 more in administrative costs per year than their Canadian counterparts.

In sum, this adds up to a $27 billion overage each year.

The U.S. health insurance bureaucracy costs doctors some $27 billion extra per year compared with Canada’s single-payer system, researchers found.

The study, published in the journal Health Affairs, found per-physician costs in the United States averaged $82,975 annually, while physicians in Ontario averaged $22,205 — primarily because Canada’s single-payer healthcare system is simpler.

The researchers also found that nurses and physicians staff spend nearly 21 hours per week on administrative duties. Those in Canada spend just 2.5 hours.

The systems, population and health factors of each nation are, of course, not identical. But these are staggering numbers — particularly on top of yesterday’s news that family health care coverage has eclipsed $15,000 per year for the first time.

The New York Times explains this in the “Survey of Employer-Sponsored Health Benefits, 1999-2011,” a joint study conducted by the Henry J. Kaiser Family Foundation and Health Research & Educational Trust.

A new study by the Kaiser Family Foundation, a nonprofit research group that tracks employer-sponsored health insurance on a yearly basis, shows that the average annual premium for family coverage through an employer reached $15,073 in 2011, an increase of 9 percent over the previous year.

“The open question is whether that’s a one-time spike or the start of a period of higher increases,” said Drew Altman, the chief executive of the Kaiser foundation.

The steep increase in rates is particularly unwelcome at a time when the economy is still sputtering and unemployment continues to hover at about 9 percent. Many businesses cite the high cost of coverage as a factor in their decision not to hire, and health insurance has become increasingly unaffordable for more Americans. Over all, the cost of family coverage has about doubled since 2001, when premiums averaged $7,061, compared with a 34 percent gain in wages over the same period.

Here's a link to the 'full study' (I didn't read): http://ehbs.kff.org/