I_Like_Dirt wrote:dobrojim wrote:Could someone please clarify this efficiency argument? Are you talking about SocSec/Medicare?
Unless my information is waaay out of date (which is possible), the govt agencies that administer
those programs have overhead rates that most corporations can only dream about, on the order of 2% perhaps.
I won't speak for anyone else here, but when I speak to efficiency, I mean at large. So to use health care as an example, Americans, per capita, are spending at the very top of the line for health care, both in terms of public funds and through private funds for insurance. Those combined mean that, per capita, America pays roughly double, or more than any other nation on earth for health care. For their expense, they get some things other countries simply don't, like better service at the top, but they also don't actually provide care for everyone, either. On a per dollar basis, the value is extremely poor overall on health care. I say this not as a critique of SocSec/Medicare, etc. I didn't have any particular target specifically in mind, although if I had to pick, I'd be targeting the likes of trial lawyers, insurance companies, drug companies, etc. There are some other layers to it as well, but those are the biggest ones that really do need to be tackled. The value of one dollar spent on health care in the USA doesn't go nearly as far as one dollar spent on health care basically anywhere else in the world.
Ironically, I actually think the one place where America does get at least reasonable value for dollar is the military. When I say this, I don't mean to say the military couldn't necessarily get better value, or that it shouldn't necessarily see a decrease in overall spending over time, but if you look at how much America spends on their military, and then lump together equivalent budgets from other industrialized countries and see what they get on a per dollar basis, things aren't nearly so lopsided and I'd actually suggest they're in America's favor, for whatever that's worth. Almost everything else besides the military, though, and the value for dollar is rather poor when compared to other industrialized nations.
Violent agreement - like you say, some of the cost drivers (leeches as you call them) are pharma, trial lawyers, hospitals (with their carveouts), physicians (when they don't allow outsourcing of medical services they don't need to provide), etc., etc....
Now, who will be willing to tackle these...
