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> Sure there is going to be waste, but once you privatise, the 'waste' will continue in the form of profit taking by insurance companies and all the other private actors in the system. Profit-seeking isn't unique to private entities. State-run programs are still subject to the exact same economic forces; the difference is solely in how they're accounted for. It's similar to the situation with state-run prisons: the profits are divvied up between the vendors who supply the prisons, the unions representing the correctional officers, and other entities who are required to make a prison actually operate. And even in state-run prisons, these entities have incentives to lobby for the expansion of the prison-industrial complex (which they do). Vendors, suppliers, and LEOs extract massive financial benefit off of the entire system, but because the program itself is state-run, we don't talk about that as 'profit'. Instead, we talk about that as the 'budget' (with a surplus/deficit). But suppose we turned the state-run system overnight into a vertically integrated, private system, with all the roles served by the exact same people. That is, all the correctional officers are the same (making the same amount of money), all of the suppliers vendors are the same (but many are now owned by the private system). Suddenly, from a discursive (and accounting) perspective, we get 'profit'. The amount of money being traded hasn't changed. The steady-state flow of money hasn't even really changed[0]. The only thing that's changed is which entities we group together as units. But they all work symbiotically in the exact same way, no matter whether you view them as a single entity or a composite system. As for the NHS - you absolutely bet that there is a profit motive amongst providers (and the agencies themselves). The language is different, and the way it gets assigned to the entities who comprise the system is different, but the fact that it's a state-run program doesn't mean that all that 'profit' magically goes back to the taxpayer. [0] There would be an overnight, single-time transfer of cash due to the overnight privatization (same thing that happens anytime a company spins out a subsidiary into a separate private entity), but the ongoing cashflow would be the same. |
That sounds like a utopia. None have been seen in the wild. Factions can form inside vertically integrated systems as well.
I also never claimed that there can't be profit taking in the nationalized system.
I only said that if there's going to be waste, I'd rather have it come from a system that isn't structured to deny care, or to make it prohibitively expensive.
Nobody likes people who are cheap. Did you ever go to somebody's house for dinner where they measure out wine with a graduated cylinder, and put out tiny portions?[1]
How about people who a cheap with the necessities of care for their loved ones? I'd rather treat everyone at the hospital like royalty, and not be cheap.
We can afford it. Just cut back on true waste like astronomical defense budgets for starters.
[1] Excluding cases where the hosts are truly poor.