Saturday, October 3, 2009

Parallel Universes Discuss the Public Option

Often, the discussion of a public option for health insurance ends up comparing the United States Postal Service and its for-profit rivals, FedEx and UPS. These discussions (okay, sometimes they'd be more recognizable if they were called shouting matches) are a fine example of how the two sides in this debate seem to exist in parallel universes.

I look at the Postal Service and see an organization that delivers mail to every home and business in the U.S. six days a week, with a regular letter costing 44 cents, while postcards and bulk mail can be sent at about half that cost or less. I see a lot of people who work pretty hard to do that. I've waited in lines to mail packages at Christmas, like everyone else, but so what?

People like Dave Aasen in the today's Star Tribune letters to the editor see a money-losing, inefficient bureaucracy that should go the way of the dinosaurs. He wrote, "Once I was about one minute past closing. The USPS employee at the door said, 'We're closed.' Probably nine out of 10 retailers would have said, 'Sure, come on in.' "

Last Christmas, I was outside the door of that one-in-10-retailers who didn't say 'Sure, come on in.' I won't name the store, but it's a smallish, specialty shop in St. Paul with hours that end at 6 p.m. every day, including the holiday season -- making it a bit hard to get to on a work day.

And here's where I find myself in a different universe than people like letter-writer Aasen. While I would be annoyed if I missed the post office by one minute, I was much more annoyed that a private retailer didn't want my business. Maybe that's because I know the postal employees don't personally get anything if they keep the building open late for me, while that privately owned retailer would have gotten something from letting me in.

Today's issue of the Strib also carried an op-ed by a retired advertising exec named Myles Spicer titled In Dismissing the Public Option, Don't Go Postal. Spicer very ably represented the same universe that I live in:

  • FedEx and UPS don't compete with the postal service for the low-cost, every-house, every-day part of the delivery business. (This sounds a lot like the argument about private schools cherry-picking the most able students, leaving the less able students in the public schools, then comparing results.)
  • The idea that a for-profit model leads to streamlining and efficiency is turned on its head when it comes to health care. "For insurers, stronger profits do not reside in streamlining anything. They rest with raising rates to the highest market price possible, then insuring only the healthy, then denying claims whenever possible. That is what increases their profits."
  • And finally, why does the postal service need to be economically self-sufficient? As Spicer wrote, "Why not make the fire department a self-sufficient local government entity? Or the police? Or our park systems? The courts? Or the military? Indeed, the Bush administration actually did partially privatize the military (there are still 160,000 private contractors in Iraq today), and the result of this profit-oriented adventure resulted in massive fraud, theft and shoddy performance."
This last point was especially resonant for me because I just saw Capitalism: A Love Story last night, and was amazed by one segment about Wilkes Barre, Pennsylvania. It seems the central Pennsylvania city (just south of DN3's ancestral home) privatized its juvenile detention facilities in the last decade. The result? Judges colluding with the entrepreneurial owners to lock up teens for things like throwing a piece of steak at a parent's boyfriend, or writing a MySpace page criticizing a school's assistant principal. Many were misdemeanors committed by first offenders. Then once the kids were sentenced to three or six months and locked up, they didn't get out when they were supposed to for no particular reason, except the company wanted to make more money off of them. Meanwhile, the privately owned company was charging the county tens of millions for their "care" and "rehabilitation."

Sorry for the tangent. Obviously, it's not directly related to the health care debate, but it's an interesting case showing how adding a profit motive to something that should be a government function can have unintended consequences.

What would it take for the people who live in these two universes to hear each other? (If I'm being honest, though, I have to admit I really mean what would it take for the people in the other univese to hear the people in my universe?)

1 comment:

Unemployed Dragon said...

The analogy that I've appreciated is that of the public and private higher education systems. Both compete for the same pool of students each year, yet the two systems co exist successfully. It seems to me that the the health systems could co exist as well.