Disclaimer The opinions expressed herein are my own personal opinions and do not represent my employer's view in anyway.
I've been seeing a lot of commentary around lately, on both sides of the issue, talking about the need to, or the danger in, privatizing something. It doesn't matter what that something is, because the arguments always goes the same way. The argument always seems to center around something which the government currently does, that some portion of the population doesn't want the government to do anymore. But what does it actually mean to privatize?
It should come as no surprise that even when privatizing something, the government doesn't actually privatize anything. Instead, it retains ultimate control over something, but allows a private entity, or non-profit organization, to administer whatever it is we're talking about under the "proper supervision" of the government that used to do it all. It's the ultimate compromise where nobody gets what they want, and things usually end up worse than they started. The liberal half are generally upset because government lost some of its control, and the conservative half are upset because government still has some control. In other words, if nobody is happy, then politicians think that they did something right.
The ultimate problem with this pseudo-privatization is that it removes the one element from the equation that any private system needs in order to succeed. The risk of failure. Seems ironic doesn't it? In order to succeed, you have to be able to fail. And yet, it's so zen in its simplicity. Risk of failure is also the motivation to succeed. It is the impetus for change and improvement. If necessity is the mother of invention, then risk of failure is it's father, waiting with a belt to kick your ass when you get home with an F.
As we all should know by now, when something that government has ultimate control of fails, it never shuts it down. It always doubles down on that losing bet, and throws more money at it, or rescues it from the hole it dug itself in some other way. Then with that new found money, that "private" entity does exactly what it did before, because it learned that if you do the same thing, you'll get more money. And yet somehow, people are always surprised when the dog starts begging at the table, after you gave it some scraps.
Then the next time someone suggests we "privatize" something, the liberals go through the list of the other things we pseudo-privatized and shows what a bad job they've done, and how we've had to bail them out. And to a certain extent, they're absolutely right. The myth is that this can be used as proof that private enterprise is less efficient than government at doing something. But if you never fully cut the cord, and let private enterprise take care of something soup to nuts, then it's not actually privatization. Call it something else... boondogglization, nonprofitization... whatever.... but it sure as hell isn't privatization.
The lesson shouldn't be not to privatize. The lesson needs to be to do real privatization and keep government out of what it used to control completely.
New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be "significantly better." ... The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care. ... [T]he National Committee for Quality Assurance today ranks health-care plans on 17 different performance measures. These include how well the plans manage high blood pressure or how precisely they adhere to standard protocols of evidence-based medicine such as prescribing beta blockers for patients recovering from a heart attack. Winning NCQA's seal of approval is the gold standard in the health-care industry. And who do you suppose this year's winner is: Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the VHA system outperforms the highest rated non-VHA hospitals. ... In the latest independent survey, 81 percent of VHA hospital patients express satisfaction with the care they receive, compared to 77 percent of Medicare and Medicaid patients.