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Originally Posted by jammies
On what do you base this claim?
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On the simple fact that as governments get bigger and need to manage more people, resources, programs, etc, etc.....the cost of doing so goes through the roof.
Imagine if a federal government would be put in charge with garbage collection in Pincher Creek, AB. And by extension, in every single town or city throughout Canada. First they would need to hire thousands of people to create the program that would manage the garbage collection. These people would probably be staffed in Ottawa, so they would have to build a big-ass building so they have somewhere to work. Then those people would need to run that program after they've spent who knows how much money on creating it and implementing it across the country. From there, they would need to hire thousands of people throughout the country in each province to look after the garbage collection and set up landfills, recycling, etc, etc. Headquarters would need to be built in each province, and maybe local buildings in certain larger sized cities. People would need to be hired to work there and organize everything. Then, the government would need to hire thousands of people to actually go out and collect the garbage.
When the municipal government looks after it, they as the governing body decide what is done based on what the citizens of that town want, and all they do is hire the actual people to collect the garbage, and those that run the landfill. It eliminates thousands of dollars that would be spent by the federal government to plan, create and execute a social service in charge of nationwide garbage collection. Certainly this would change in a city like Calgary, where they probably have fulltime workers dealing with garbage disposal on an administrative level, but those workers deal with the city government. And not a whole other layer of red tape in Ottawa.
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There are large fixed costs that are the same no matter what level of health care you are providing - hospitals and clinics need to be constructed, drugs need to be bought, diagnosis machines purchased, etc. Then there are the human costs of staffing and administration. Nowhere does that cost MORE than 10x as much to serve 10x as many people; properly run, economies of scale should make it LESS costly for things like administration.
On the flipside, sufficiently large organizations have a tendency to not be properly run, which usually obviates the theoretical cost savings, and also tend to be inflexible, which can cause problems if you are trying to deliver a service in many different locations with different local needs. So you have to balance between being too small, and being too big.
If *I* were in charge of creating such a system, I would set it up in some ways much like a Walmart or Costco - all purchasing would be through a central agency to allow that agency to drive the costs of expensive medical equipment and drugs down. In other ways it would be much more like a municipal government model, where there would be thousands of local *elected* health organizations responsible for delivering health care and universal insurance in their area, and supported by a budget drawn half from local tax and half from federal funding derived from a per-capita flat rate, which would serve to somewhat alleviate the inevitable difference in funding available in poorer areas from richer ones.
Private hospitals and clinics would be allowed, but would have the choice of working within the system at scheduled rates and with budgetary transparency, or outside the system entirely. Much like we have in Canada now, doctors would work under the aegis of the local health authorities, and would bill directly to that authority.
I think the key is to identify what needs to be organized on each level, and divide the responsibilities appropriately. I also think that elected health boards are important, as that drives accountability.
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I tend to agree.
Far as I'm concerned, private clinics should be allowed and even encouraged to be setup, and for a certain fee per month, people would get basic health care. X-rays, blood tests, prescriptions, stitches, etc, etc. What this would do is stop those idiots who go to the hospital an infinite amount of times because something 'hurts.' And don't tell me it doesn't happen because doctors here in town complain all the time about such patients.
It would also clear up emergency rooms, and allow hospitals to treat more serious patients without having to deal with someone who needed stitches. When you need surgery, it is covered by public health care. When you need a MRI, it is covered by public health care. Any kind of serious procedure would be covered by public health care. Everything else? You pay a certain fee, per month, to get your basic health care. The idea wouldn't be to cover the costs, but to encourage people to not take advantage of the health care system.
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And yes, if you're doing drugs, your fee will go up. Anyone that intentionally goes out of their way to be a bigger drain on our health care system should have to pay MORE to receive basic health care. And no, I'm not talking about making you pay $100/month for that health care.
I'm still debating as to whether or not that should apply to obese people too, because the government is partly at fault for making them obese in the first place.
And for those of your who don't like the idea, there is, or was a clinic down in Texas that implemented a system like this and it was hugely successful. People were receiving good health care for a very low cost.
Well, until the IRS and the Federal Government came along and told them to shut down.
