The Duty of a Civilization and Weaponized Naivete

[seawasp]

Cut for length...




One of the common, and deliberately selective, critiques of aspects of the government that are primarily focused on helping people is that they are expensive; the Post Office, for instance, is often kicked at for "losing money". 

Similarly, Medicare-For-All or similar universal healthcare concepts are derided as just people wanting "free stuff" and doing so on "other people's money".

Both of these also have superficially similar, commercial equivalents that these people will tout as superior -- that "private enterprise" and "competition" will naturally lead to better, cheaper outcomes. 

These arguments rely upon the naïve and simplified perception of the situations. By presenting the Postal Service's budget in a particular way, it certainly does look like a money sink, and since we have profitable businesses like UPS and FedEx that are, superficially, just like the USPS, clearly there's something wrong with the Postal Service. The arguments against universal healthcare usually rely on one of three general supporting pillars of misleading and naïve perception: painting universal healthcare as demanding people work for nothing, arguing that implementing it would be ruinously costly, and arguing that it's unfair for other people to be paying for your "free" healthcare. 

All of these are weaponized naïveté, deliberate and misleading uses of the normal human limitations of understanding of situations that are not in their main focus of understanding. 

As I've stated before, the purpose of a government is the support of its citizens -- the maintenance of the civilization so that people can prosper with the minimum necessary level of limitations to their choices and actions. 

This is based on the proposition that human lives have a default value -- that every human being has some kind of worth separate from whatever specific achievements they may have accomplished, starting from the moment they're born. 

The framing of the Postal Service as "losing money" is really like saying you're "throwing money away" when you're paying for your electricity, water, or phone service. You're not: you're paying money to ensure those important services continue to be provided so you can function well. 

The Postal Service is a SERVICE. It's there to provide a (Constitutionally mandated) method for official and private communication that is always available and always affordable. Naturally that has a cost. 

But that cost is FAR LESS than a privatized version would be -- or to put it another way, the SERVICE obtained from that money is far greater that it would be if privatized. A corporatized, profit-oriented company handed the USPS' mandate would have only two real choices: 1) charge a lot more for every letter delivered, simply because they'd need to add some kind of profit margin on top of the costs of delivery, or 2) drastically reduce services to anyone who wasn't a significant customer.  Likely, it would be BOTH -- charge more AND cut services. 

The same applies -- in spades -- to healthcare. Unlike the USPS, which is still holding on as a service, barely, healthcare was opened to profit-focused companies back in the Nixon era, so we can now take a look at the results. 

And those results are exactly what one would expect. Companies attempting to run healthcare services treat them as income streams. They don't view themselves as being primarily service providers, because they're run from the top to provide profits for stockholders. A properly-run hospital, for instance, SHOULD have a lot of empty, unused beds at almost all times so that emergencies can be properly addressed -- when a bus overturns and forty-seven people are suddenly brought in for treatment, you don't want them spending hours waiting for proper rooms. A properly-set up ER should have plenty of doctors and nurses so that any normal traffic through the ER can be quickly and efficiently dealt with. 

That's anathema to a business, of course. Paying for the maintenance of a bunch of empty rooms (that have to be kept clean and ready for patients at any time) is inefficient; the rooms should ALWAYS be in use. There should be no nurses or doctors standing idle for more than a moment or two -- we're paying them, after all. 

And for healthcare, another industry built on top of it makes the cost vastly higher, and the service vastly worse: the insurance industry. The original CONCEPT of insurance was to spread the cost of all healthcare among a larger pool of people. The modern version is to attempt to minimize all costs of actual healthcare in order to retain the money paid for the insurance. 

Ironic, then, that "universal healthcare" is simply the original concept for insurance writ large; the costs of healthcare spread across the entire nation so that we all are supporting each other. But with a SERVICE focus, and no profit requirement, the cost of that service overall will be far less. 

Of course, that means absolutely erasing 99% of the existing health insurance industry, which isn't gonna go without a fight. 

To fight, of course, they make more use of weaponized naïveté and misleading framing, by pointing to failures of other universal healthcare services as though these invalidate the concept. 

But of course, what is relied on there is that most people have minimal grasp of actual statistics, and a strong preference for any personal experiences, or ones they relate to their personal experience. And when arguing against a change, pointing out any failure of the opposed system gives the impression that this failure is COMMON -- or that ANY failure is unacceptable. 

No human service or endeavor is perfect, but those fighting against such changes will use any imperfection as an argument against change -- even though an unbiased look at each side would reveal that the "imperfections" are present in both, and MUST be present because no one, and nothing, is perfect. 

The important question with respect to comparing the health services approaches is "how likely is the average person to receive timely, appropriate treatment rather than either less effective or less competent treatment?" -- and those fighting the idea of universal healthcare quite deliberately SEPARATE OUT the key element that reveals the true answer:

How many people choose to AVOID treatment, or delay it until the outcome is, of necessity, worse. In the USA, anyone who isn't quite well-off is ALWAYS going to be weighing the cost of a medical visit, ranging from just talking to the doctor to getting a required surgery. The proper cost that SHOULD be weighed is, "will this likely help me live a better life?", but here in the USA, the question is "can I even manage to pay back the cost of this visit?"

That, alone, shows that our current version of "health insurance" has failed in its execution; the whole point of insurance was to make medical support affordable, but instead it has become a tool to reduce use of healthcare services because the average person can't afford it. 

In essence, we've doubled the cost of healthcare and reduced its safety and effectiveness because we've been convinced that "other people's money" is somehow better off in the hands of an insurance company than the hands of a government service provider, BOTH of which are run by fallible people who will undoubtedly sometimes screw up, deliberately or accidentally, and that it's somehow better if it's a private company with less accountability to anyone except the stockholders.

 

The "demand for perfection -- but only on one side" approach is, in fact, a major tactic and stumbling block in modern politics, and I should probably make that another post. 

 

 

Comments

[sturgeonslawyer]

Another fine post.

You are describing two symptoms -- the healthcare system and the USPS (I am old enough to remember when it was the US Post Office) -- of a larger plot against the people of the United States; one so large as to be difficult to see. It may have begun, as you suggest, under Nixxon or even earlier, but it took firm root under (ptui!) Reagan. It has no name, that I know of, unless it's something awful like "oligarchicization." It is hard to see the whole thing, but it has many manifestations that are not; a few of which are:

• The rapid shift from stakeholder corporate management to shareholder corportate management, around 1982-6.


• The dismantling of the protections (I'm looking at you, Glass-Steagall) put into place in the wake of the Great Depression.


• The monetization of the electoral system, culminating in Citizens United, which essentially put government in the hands of the 1%ers.


• The gradual trend to subservience of the mainstream media, managed by a variety of means ranging from intimidation to purchasing the controlling companies (can you say Jeff Bezos? I knew you could), thus making it hard to rebel because most citizens don't even realize that there's something to rebel against until it's too late.

I and my family are abandoning ship - somewhat against my will, but my beloved spousal overunit is adamant, and I'm not going to give up nearly fifty years of marriage to fight a battle against seemingly-impossible odds, at my age. As the man said, "The past is dead, the present stinks, and even the future ain't what it used to be."

[seawasp]

It has a name: Project 2025, or, to be accurate, "A Mandate For Leadership", which is the name the guiding document, produced by the Heritage Foundation, for pretty much everything you're talking about, and has been since the first version of that document was given to Ronald Reagan when he was elected. The Heritage Foundation and its associated groups are the direct, knowing, and specific architects of the entire transformation.

I didn't believe it at first, but then I read ALL of Project 2025, and right at the end, in the afterword (titled, of course, "Onward!"), there it was: the guy who primarily wrote the FIRST VERSION of Mandate For Leadership described exactly how it had happened and how it had been a systematic plan to counter the advance of basic civil liberties and secular sensible governance. The same guy had been there from the beginning. They'd intended this outcome since before 1980. Barely-concealed white supremacists crossed with fanatic apocalyptic Dominionist "Christians".

I'd like to try "Abandon Ship" but that requires resources I do not have.

[kengr]

That bit about not having empty rooms or "idle" personnel is part of a far too common misunderstanding of statistics. This distorts pretty much *any* "service" industry (grocery stores are a good example)

The misunderstanding has to do with "average (and a related but lesser known statistical property that I believe is called t-scores)

If you staff (or provide rooms, etc) for "average"load/traffic, then that means that 50% of the time you will not have enough staff or whatever. That's essentially the *definition* of average (mean).

What really needs to be done is decide what percentage of the time you are willing to be under-staffed. 100% is impossible, of course and getting close *will* be unreasonably expensive.

But is you use that other measure (t-scores? it's been a *long* time since I worked with stats) can can use statistics to see what you'd need for a given service level and plan for *that*.

Of course, that costs more money. But in a *rational* system, that'd be seen as a cost of doing business rather than waste.

Frankly, I'd *love* to see the laws *require* critical services (not just healthcare) to be set up to handle some specific "load". 75%? 90%, 95%?

Of course, the screams would be audible in orbit. But the reality is that if they can't handle emergencies, they shouldn't be in business in the first place.