2010/06/26

How I Became a Socialist, Part Two: Government Efficiency

If you talk to people about government waste, you'll inevitably hear about the $500 dollar toilet seats that are paid for by public money. The problem is that these are not examples of government waste, they're examples of private companies ripping off the government. Those $500 dollar toilet seats were sold by private companies in "public" bids (the scare quotes are used because frequently the only people to know about these bids happen to be friends or financiers of some public official involved in the deal) and because the various regulatory arms of the government have been weakened and eroded by decades of corporate lobbying, no one's able to check to see who's paying for what before the checks are signed.

The government can, and does, run efficient programs, but only when they're actually run by the government, not by handouts to private industries. To give a local example, I'll use the Salt Lake County Library System. In 2008 (the most recent year data is currently available), they had a budget of about $30 million. For a population of one million, that's an average of roughly thirty dollars a year (which would be graduated by income in practice). To pick a point of interest (I'll admit it's not at all perfect, but it's the closest I can think of), the standard Blockbuster membership is $204 a year. Again, it's not the best comparison for a variety of reasons, but in the interest of focusing on issues of local interest, I'm going to use it. The most pertinent issue with this example is that, of course, everyone who pays taxes in Salt Lake County pays for the library, but only people who go to Blockbuster pay for that - but our library system has especially deep penetration, with roughly 50% of the population registered, I believe, and even if you assumed that only a small part of those used the library on a regular basis, the Blockbuster membership would still be more expensive or, perhaps, about the same price. And, in the library, you get a whole lot more than just DVDs, you get books, audiobooks, music, computer access with high-speed internet and word processing, regular events like story-times for children and such, as well as at least one professional on staff at all times that's trained specifically to help you find the information you want to find - and you get as many of these items as you can use, whereas the Blockbuster membership has a limited number of rentals (except for their DVD-by-mail program, but even then you only get 2 DVDs at a time, compared to 10 with the library). Still not a perfect example, but I think it illustrates pretty clearly that the government can run an efficient and effective operation. And, when I worked there during the last recession, they made a commitment not to lay off a single person when every private business was shedding employees like a cat in summer. They instituted a temporary hiring freeze, yes, and they didn't immediately replace a few employees who retired or left for other reasons, but not a single person was laid off - and, mind you, even their 20-hour employees are eligible for health insurance and receive paid sick leave and vacation time.

To give a couple national examples, there's government-run healthcare (pertinent quote: "In 2000 the United States spent considerably more on health care than any other country, whether measured per capita or as a percentage of GDP. At the same time, most measures of aggregate utilization such as physician visits per capita and hospital days per capita were below the OECD median. Since spending is a product of both the goods and services used and their prices, this implies that much higher prices are paid in the United States than in other countries."), and private contracting in Iraq (pertinent quotes: "Over the course of several years, the Defense Contract Audit Agency found that $553 million in payments should be disallowed to KBR, according to 2009 testimony by agency director April Stephenson before the bipartisan Commission on Wartime Contracting in Iraq and Afghanistan. ... Some of the overbilling in Iraq appears to have been done from haste or inefficiency, or even in a desire to please military officials in the field without regard for cost.")

So, in short, while there are undoubtedly some things that private industry is better at, and government is worse at, there's no reason to assume that just because the government is running it that it will be less efficient. To the contrary, the opposite is frequently true.

5 comments:

  1. Regarding government-run healthcare, I don't see in your blog here where a comparison is made between private and gov't-sponsored. To state how much was spent doesn't tell me anything. Or am I missing something?

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  2. I forgot to mention, county government FTW.

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  3. @Robin:
    The United States is, I think, the only country left in the world to rely on private health insurance. Pretty much everyone else has moved to a health care system run primarily by the public sector(except for, I believe, countries that are essentially too poor to afford health insurance at all). So, if you're comparing health insurance in the U.S., and health insurance in the rest of the world, you're also comparing private health insurance to a government-run system.

    The link I provided may not have been the best one, so let me try another one, this time by the WHO: "The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18th." In other words, we're spending the most, but getting health care that's generally worse than almost every country in Europe.

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  4. What defines "performance" according to the WHO? I'm wondering if the US spends far less on preventative or lifestyle-related health care (i.e., get some exercise instead of taking a HBP medication) and that is the cause of the poor finding. That may not account for all of it, but is it part of it?

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  5. @Robin:
    If you take a look at the link I provided, it describes towards the end of the article what the WHO meant by "performance", which is too long to copy and paste here.

    It's probably true that the U.S. spends less of preventive care than other nations that rely more heavily on public health systems, but it seems to me this would underscore why government health care works better than private, since private insurance companies make money by getting people to pay for treatments (whether they're reimbursed later or not). If someone gets too sick to be profitable, you can just dump them. Universal, governmental health care, on the other hand, makes the most money by keeping people healthy, since the government is still responsible for people even after they get sick.

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