That sounds like a good stop gap to me. - Edit 1
Before modification by Joel at 03/09/2009 09:52:21 AM
Here public administrations (like your Medicare would be I guess) have to ask a price offer from at least 3 or more suppliers before making a contract with one company (must be the cheapest be justified otherwise, some other valuable advantage). It is mandatory whenever publi money is involved.
The theory is good though I must admit there are lots of problems still present, corruption, red tape increase, ...
Without being called a socialist (though in American standards, my political views probably are more on the left than on the right, being European), I'm for the idea of a state-controlled organization ensuring medical care for everyone, even those without a job or money... Now that said, it should be run effectively, and politics being politics (same everywhere), it ain't easy...
I'm still trying to figure out what would be a better solution, but so far I haven't found anything..
*prepares to be flamed*
Yeah, well, keep us posted (so to speak. ) My long time refrain in the Great Debates CMB6 saw near the end was "the system is broken; if you have a better alternative, please share it. " So far, no takers, not even among Republican critics in Congress....
The argument seems to be the problems was no competitive bidding. Negotiating a price only works if you can tell a wholesaler "your competitor offered me exactly what you have at half the price. " Which isn't a panacea either, if you'll pardon the pun, particularly with things like this; I was born in Houston, and, while it was before my time, I understand they had a saying in the hey days of the Moon race: "Just remember when you're hurtling into orbit at 30,000 mph: You're doing it on lowest bid.... " In this case though it looks like we had the opposite problem, and one that anecdotally arises with Medicare a lot: Medicare doesn't price shop much, and it doesn't negotiate much, which sometimes means it pays a lot more than market prices to keep the good will of seniors, who reliably vote in far greater numbers than any other demographic, and other times means healthcare providers either accept nominal Medicare payments and eat the loss, or try to collect the difference from patients who can't afford it.
Far be it from me to speak for Tom or anyone else, but I believe there are those who would say that IS the fundamental nature of socialized medicine. I don't think it's inherent, though it is sadly prevalent, at least over here, but I've always understood that to be the crux of the argument.
This would be the corruption and/or inefficiency detractors decry in government bureaucracy. Because it NEVER happens in CORPORATE bureaucracy, you see.
The theory is good though I must admit there are lots of problems still present, corruption, red tape increase, ...
Without being called a socialist (though in American standards, my political views probably are more on the left than on the right, being European), I'm for the idea of a state-controlled organization ensuring medical care for everyone, even those without a job or money... Now that said, it should be run effectively, and politics being politics (same everywhere), it ain't easy...
I'm still trying to figure out what would be a better solution, but so far I haven't found anything..
*prepares to be flamed*
Yeah, well, keep us posted (so to speak. ) My long time refrain in the Great Debates CMB6 saw near the end was "the system is broken; if you have a better alternative, please share it. " So far, no takers, not even among Republican critics in Congress....
There are n suppliers of wheelchairs. There is one very large organisation (Medicare) which will always need to buy lots of wheelchairs. Any supplier that can get a bulk purchase contract with Medicare will make a fortune. Also, since Medicare is government run, they've got the possibility of throwing a tax break for the supplier into the deal as well, if they want to. So Medicare should be in a really good position to negotiate cheap bulk purchase rates for wheelchairs.
The argument seems to be the problems was no competitive bidding. Negotiating a price only works if you can tell a wholesaler "your competitor offered me exactly what you have at half the price. " Which isn't a panacea either, if you'll pardon the pun, particularly with things like this; I was born in Houston, and, while it was before my time, I understand they had a saying in the hey days of the Moon race: "Just remember when you're hurtling into orbit at 30,000 mph: You're doing it on lowest bid.... " In this case though it looks like we had the opposite problem, and one that anecdotally arises with Medicare a lot: Medicare doesn't price shop much, and it doesn't negotiate much, which sometimes means it pays a lot more than market prices to keep the good will of seniors, who reliably vote in far greater numbers than any other demographic, and other times means healthcare providers either accept nominal Medicare payments and eat the loss, or try to collect the difference from patients who can't afford it.
Apparently that's not what's happened, but surely that's because someone in Medicare's pricing department is an idiot, rather than due to the fundamental nature of socialised medicine.
Far be it from me to speak for Tom or anyone else, but I believe there are those who would say that IS the fundamental nature of socialized medicine. I don't think it's inherent, though it is sadly prevalent, at least over here, but I've always understood that to be the crux of the argument.
Also, I'll bet it'll turn out that the $4000 cost to medicare includes extras, like the salary of the person who liaises with the supplier, delivery, and other associated costs; whereas the $1000 supplier's price quoted is just the basic price before sales tax.
This would be the corruption and/or inefficiency detractors decry in government bureaucracy. Because it NEVER happens in CORPORATE bureaucracy, you see.