If The Government Ran the Air Force…
One of Megan McArdle’s correspondents rants against the evils of the DC Department of Motor Vehicles before snarking ” I can’t wait for the government to take over our healthcare system.”
A common enough sentiment. But look — the government already runs a fleet of air craft carriers. Worse! The government’s taken over our national monetary policy — mistakes can plunge the country into recession or a destructive cycle of inflation. And as if that’s not enough, they run a vast arsenal of nuclear warheads capable of destroying the entire planet. Which is just to say that if it’s not conceivable that there could be a well-managed government agency, then we’re all doomed irrespective of what happens with health care. But in fact if you look across the country or around the world, you see some highly effective public agencies and some highly dysfunctional ones. Obviously, you wouldn’t want the health care system run like the worst of those agencies, but that’s hardly to say that a highly effective government health care agency would be impossible to achieve.
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August 14th, 2008 at 9:05 am
And of course we already have some government health care agencies.
August 14th, 2008 at 9:14 am
1) Wonder what Megan McArdle would say about the evils of government if she was dropped in a lawless region and gangbanged by three large criminals.
2) Probably she would become those criminals’ hanger-on — since Republican life strategy consists of finding the local power figure and ..er.. sucking up to him big time in exchange for a few crumbs.
The best part about the strategy for Republicans is that it doesn’t require intelligence or competence — an earthworm could do it.
August 14th, 2008 at 9:23 am
Of course McArdle is a profoundly silly person, but–if a fireman plucks her from a burning building minutes before the timbers collapse in a fiery heap, will she be for universal healthcare then? Same reasoning either way.
August 14th, 2008 at 9:24 am
What happened between you and McArdle that makes you link to her moronic drivel?
This totally rings of “my ex-girlfriend said WHAT?”
August 14th, 2008 at 9:26 am
If only the gubmint could possibly make managerial decisions with the awesome efficiency and thinkerrificness of General Motors, whose record of success, smart investment, forward-thinking product choices, and financial judgment make us all swoon with appreciation for the Fee Mahkit.
August 14th, 2008 at 9:30 am
The government run VA system is widely recognized as being one of the best run agencies in the government. Remember - most of those problems you’ve been hearing about military health care for returing vets from Iraq and Afghanistan has been about DoD and not the VA. The VA provides health care for millions.
This is something that free market conservatives really don’t want to talk about because it validates the points that people make about government run health care.
August 14th, 2008 at 9:37 am
It might also be meet to point out to Megan that nobody is suggesting that the health care system be managed by the Mayor and City council of the District of Columbia.
August 14th, 2008 at 9:39 am
Why do you take Megan seriously, Matt? She’s a selfish idiot.
Incidentally, did anyone see Sadly No’s most recent and comprehensive takedown of Matt?
http://www.sadlyno.com/archives/10710.html
It’s seriously awesome (follow the links, there’s some really surprising material for newer/less attentive Matt fans). Is Mr. Yglesias still doing request threads? Maybe we could get him to excoriate a few of these horrible posts?
August 14th, 2008 at 9:47 am
I’ve dealt with the DMV in New York and my health insurers and the DMV experience was a lot more pleasant.
August 14th, 2008 at 9:50 am
You can go farther than you did, Matt. The difference between when the government ran the Air Force, or rather our military generally and when it was run for profit by private contractors does not flatter the private sector. The military has always been a giant government bureaucracy (SNAFU is a WWII-era expression), but back when its ultimate goal was fighting and winning wars (rather than maximizing profits to return to shareholders), we were at least as successful as we are now–and a lot more cost-effective.
August 14th, 2008 at 9:50 am
As calipygian correctly notes, one of those highly effective public agencies happens to be the Veterans Administration, particularly its system of providing long-term healthcare to vets. This is a recent editorial from the American Journal of Public Health, but it cites much of the recent evidence showing the VA consistently outranking market-based private healthcare in terms of cost and health outcomes:
http://www.ajph.org/cgi/reprint/97/12/2124
Makes me wish I could trade in my crappy Blue Cross coverage for some government-run healthcare.
August 14th, 2008 at 9:56 am
Yawn. Health care reform is meaningless if it lacks outcome-based rationing. Spending hundreds of thousands of dollars on heroic treatments to prolong a dying person’s life a few weeks or even days, when the chances of long-term survival and quality of life are both zero, is a receipe for national bankruptcy, not to mention barbaric. And whatever happened to the quaint concepts of “medical research” and “preventative medicine?”
August 14th, 2008 at 9:57 am
This could all change very rapidly now but the care and upkeep of nuclear weapons saw a massive and rapid decline when it lost salience as a priority. At one time, commanding NORAD was a fast track job to the pentagon and when it was I won’t say nothing went wrong, but it was something worth doing right.
Post cold-war, when NORAD became seen as an anachronism, it wasn’t a plum job anymore. It was a backwater, and that’s when you started to see incidents like the flight of real nukes mistaken for dummy warheads.
I think it has ominous parallels for a future Bush type administration who would appoint someone hostile to a public health sector to administer it.
August 14th, 2008 at 10:00 am
The DMV is a much more appropriate comparison to government-run healthcare than are military agencies. Like clinics and hospitals, DMVs deal with serving everyday people and shuffling through a bureaucracy. Military agencies involve a relatively small number of highly-trained individuals with a strict system of hierarchical control.
Other examples of successful government agencies are needed.
August 14th, 2008 at 10:00 am
If you read McCardle’s complaints, they are actually, in some ways, about the decentralization of responsibility. Part of what has her and her commenter upset is that DC and PA aren’t in sync. In fact, a nationalized DMV system would have likely avoided McCardle’s problem. So, the whole DMV rant of McCardle and her readers are an argument FOR nationalized healthcare.
August 14th, 2008 at 10:10 am
You stay classy, Don Williams.
August 14th, 2008 at 10:10 am
I’ve dealt with the DMV in New York and my health insurers and the DMV experience was a lot more pleasant.
Right. It’s not that any organization is flawless but do people really find their interactions with the IRS, USPS, SOS/DMV, etc. vastly inferior to interactions with cable companies, utilities, banks, tech support, etc. We can influence the govt agencies through the free market of voting/political participation as much as we influence the private companies through the free market of spending money. I’ll have a new governor before I get access to new broadband providers.
August 14th, 2008 at 10:10 am
I understand that we tolerate massive inefficiencies in military spending because it’s a matter of “national security,” but isn’t the same true for the provision of adequate healthcare?
August 14th, 2008 at 10:12 am
Christopher Monnier,
Again, I suggest looking at the existing government health care agencies, like the Veterans Health Administration and the Centers for Medicare and Medicaid Services.
August 14th, 2008 at 10:13 am
Actually, the VA healthcare system oversees 7.8 million enrollees, which includes wives and children who may or may not be highly trained individuals.
By way of comparison, Kaiser Permanente oversees 8.7 enrollees. Badly.
August 14th, 2008 at 10:14 am
Libertarian here. Some of us think that the government running the air force and the military generally HAS been a disaster. We have a world-wide empire that has slaughtered untold thousands of people; we’re the only country to have used an atomic bomb on a civilian population and we continue to oppress and control an enormous number of regions.
Minarchist libertarians often argue at least against a standing army (as the Founders did), whereas anarchist libertarians argue that competing, private defence forces would be cheaper, more efficient, and more just.
So anyway, this radical libertarian is fine with your analogy but he thinks it entails getting rid of government monopolized, funded and operated military services along with government monopolized, funded and operated healthcare services.
Oh and Don Williams’ first comment in incredibly offensive and sexist.
August 14th, 2008 at 10:30 am
apm: We can influence the govt agencies through the free market of voting/political participation as much as we influence the private companies through the free market of spending money.
Well, we can influence the government agencies, but not nearly to the same extent. A person voting with their dollars does so because they believe they can (and typically do) get better goods and service from the competition. A person voting with their votes is unlikely to be casting the vote that determines the winner, and thus are merely hoping to get better goods and services from the government. Furthermore, they are at odds with organized blocs of voters and special interests. Not to mention that most government agencies are staffed by bureaucrats not up for election, making the degree of control even lower. And perverse incentives exist: a government agency or program that does a bad job often gets more money thrown at it.
Thus, our political system isn’t nearly as responsive to its consumers as the market is.
Also, there’s a pretty compelling economic argument that mismanagement of the money supply was exactly what made the Great Depression so “great.” As for the military, it at least has some incentives to do a decent job because an ineffective military results in losing wars, which is bad politics that would result in less resources for the Military Industrial Complex.
BTW, why is there no Preview button?
August 14th, 2008 at 10:43 am
God, what a nightmare it would be if health care in America were paid for by giant impersonal inefficient bureaucracies. It’s almost unimaginable.
August 14th, 2008 at 10:46 am
The gubmint also oversaw the early development of this very Internet we are using now; at at time when private enterprise was giving us Compuserve, Prodigy, and the old AOL.
August 14th, 2008 at 10:49 am
A person voting with their dollars does so because they believe they can (and typically do) get better goods and service from the competition.
But in reality this isn’t a smooth or reponsive mechanism either. I vote with dollars for Comcast, General Motors, and Microsoft. I am not at all completely satisfied with their goods and services. Their competitors have superior qualities in many areas although I would not be completely satisfied with them either. These choices are complicated and based on availability, value, and the dumb choices of others (e.g. Microsoft’s market-share leads to compatibility and professional considerations when purchasing).
And with health care, most of us are especially powerless. When MediCorp buys our employers’ MomNPopPPO, raises premiums and lowers services - how do we efficiently vote with our dollars?
August 14th, 2008 at 10:53 am
Apparently, the new Air Force Chief of Staff doesn’t think that service has been run very well over the past few years.
http://www.washingtonpost.com/wp-dyn/content/article/2008/08/12/AR2008081202864.html
By the way, Mr. Don Williams and Mr. Trevor must be gnashing their teeth in frustration over the ethnic background of General Schwartz.
August 14th, 2008 at 11:04 am
The Air Force probably wasn’t the best government agency to pick. There have been a number of recent problems with their stewardship of nuclear weapons-they lost track of a number of nuclear weapons and then flew them across America before anyone noticed as well as accidentally sending nuclear weapons components to Taiwan.
Also there is the wider criticism by the other branches that the air force doesn’t spend its money the way its needed. Rather than buy aircraft suited for close air support and counter-insurgency work they buy the far more expensive and glamorous F-22s. Air force procurement and other policies do often seem to be driven more by defense industry lobbyists and generals trying to justify a set of outmoded missions than the needs of the United States.
I’m willing to concede that there are some government agencies that are managed well. I’m not exactly sure which they are but it is conceivable. I doubt that,particularly in the face of the so many entrenched interest groups like the big pharma, AARP etc. that health care would be well run.
August 14th, 2008 at 11:05 am
And as if that’s not enough, they run a vast arsenal of nuclear warheads capable of destroying the entire planet. Which is just to say that if it’s not conceivable that there could be a well-managed government agency
Is Matthew seriously asserting that the air force - the government agency running nuclear weapons - is a “well-managed government agency”?
Really???
When they recent lost track of 5 nuclear bombs???
And, you know, it’s not like this is the first time that’s happened - in fact, the military has lost a nuclear weapon before and never found it!
If that’s the example that Matthew’s using to show that the government can run important things well, we’re all in deep do-do.
August 14th, 2008 at 11:11 am
“Thus, our political system isn’t nearly as responsive to its consumers as the market is.”
Look, kids! It’s tired Libertarian Canard #4373!
Look, we’re all familiar with the theory of people voting with their dollars, but it doesn’t fly in the real world. Corporations exist to turn a profit, not to make their customers happy. Competition is almost entirely price-driven, not service-driven. If the numbers are right, they’ll offshore their customer service to Bangladesh, put a wall of robots between callers and service representatives, deny your claims, sock you with hidden fees, jack up your interest rate to levels that would have been deemed criminal by Caligula, and rewrite your contract unilaterally. Because it is in their financial interest to squeeze every last dime of you they can without actually losing your business. And they know they won’t lose your business, because they know their competitors are just as consumer-unfriendly as they are. We’ll buy the product at the right price regardless of how the company treats people, and we’ll stick with a crappy service because it costs time and money to switch.
I’ve been fighting a long-running multi-front war with the Kafkaesque bureaucracy of the Maryland Motor Vehicle Administration for several years. But I’ve never, NEVER encountered worse customer service in the public sector than I’ve received from profitable major corporations. Or even unprofitable ones, like Sprint, that would seem to have a vested interest in improving their service but still manage not to.
August 14th, 2008 at 11:16 am
apm: But in reality [the market] isn’t a smooth or reponsive mechanism either.
All I am saying that it’s more responsive than the political channel, which faces the distortions I mentioned as well as others. Note that you only get two choices — if that (redistricting creates a lot of safe seats). If neither choice satisfies the consumers — which is often — we’re still stuck with them. Whereas if two products in a market are not satisfying the consumers, there exists an enormous profit incentive to come up with a better product.
Furthermore, voters for the losing candidate have zero say. Consumers of niche products, on the other hand, do have a say, because their satisfaction results in a percentage of the market share going to the producers that satisfy them the best. They thus have a proportionate share of the economic resources. Unless we move to proportional representation, our political market behaves nothing like that.
August 14th, 2008 at 11:27 am
Another libertarian here… Much of the reason we went in to Iraq is b/c we’re spending so much on the military and the gov’t wanted to use it. (Not to mention that much of our current econ trouble was due to the fed holding rates low and that we have actually nuked people…)
Not all government agencies are horribly screwed up. Not all private enterprise is well-run. It’s a question of which is better on average.
August 14th, 2008 at 11:28 am
LaFollette Progressive: Corporations exist to turn a profit, not to make their customers happy. Competition is almost entirely price-driven, not service-driven.
Likewise, politicians are incentivized by winning elections, not making the citizens happy, and there are differences between the two just like profit is not an exact proxy for customer satisfaction. Due to a variety of factors, including the fact that there are only two major parties, voter turnout is low. Redistricting and the Electoral College means that a lot of those voters are irrelevant because they really face only one choice. This means you’re talking about two sets of people. Furthermore, political support from organized or moneyed interests are more valuable than disorganized and/or poor voters.
LaFollette Progressive: But I’ve never, NEVER encountered worse customer service in the public sector than I’ve received from profitable major corporations.
Bush won two elections, and even after most everybody regretted him winning the 2nd one, we couldn’t get him out.
August 14th, 2008 at 11:40 am
Matt, I’d argue that the fundamental issue isn’t that all things done by the private sector are good and those done by the public sector are bad. As you point out, that’s false, but it’s also a straw-person argument.
It’s that, all other things being equal, more responsive structures will provide higher quality goods at lower costs. Government, being a monopoly, and running through a vote market, is less (not un-) responsive than a big company. Small companies are far more responsive than big companies.
It’s not that every time the government takes something over that the good service goes to hell, or that every lousy service becomes great on privatization, it’s that there is a shift on the “efficient and cheap” vs. “clunky and expensive” axis.
What about the military and such things? Well, I bet we’d have a cheaper military (not hard to imagine, right? You’ve heard the horror stories of the Pentagon procurement process, right?), and it would probably be much better at killing people (harder to imagine, but I’m an imaginative guy).
So why don’t we do that? As Thomas Hobbes pointed out, a lot of private use of military force leads to a war of all against all. The mechanism by which private armies compete to show who can provide the best security is that they fight wars with each other. The 30 Years’ War isn’t a bad example.
So we put up with the waste, inefficiency, and occasional lost nuke of a national military because there is a clear, specific argument as to why encouraging small private armies is bad.
I think there’s a good, strong case to make that “single payor” run by the Federal Government would be better than “3 HMOs, Medicare, Medicaid, and a few struggling independents”. i just don’t think that case rests on “central planning can too do things right!” Of course they can. The question is whether they do it better in a given sector of the economy.
August 14th, 2008 at 11:40 am
Sorry. Had italics issues in the last post…
August 14th, 2008 at 11:42 am
By the way, it’s a good thing that corporations give lower prices a higher priority. A lower price means all its customers have more money to spend on other things, thus increasing their standard of living. It also means that more people will be able to afford the good.
On the other hand, only a minority of customers well deal very much with customer service. Spending more on customer service increases your costs, and thus the price you must charge. It does not make sense to hurt all your customers (and potential customers) to satisfy a vocal minority.
That this happens with regularity in politics (e.g. agricultural subsidies) is exactly one reason our political market doesn’t work very well.
August 14th, 2008 at 12:07 pm
Obviously, you wouldn’t want the health care system run like the worst of those agencies, but that’s hardly to say that a highly effective government health care agency would be impossible to achieve.
That’s just not fair. It’s not like the federal or state government have any kind of track record of running a healthcare or health insurance scheme. So the only option for legitimate commentary like McArdle is to cherry pick examples of government agencies like the DC DMV
August 14th, 2008 at 12:38 pm
I remember dropping off my family at the airport in 2002 when the TSA had just taken over, and the luggage-screening process was easy and efficient; TSA employees politely directed us, asked us questions and that was that. Then dealing with the airport Burger King was an experience I describe as Soviet-like. Sent from one window to another by people who affected unfamiliarity with the concept of a BK kids meal and no interest in helping us buy one. Same with the parking garage. But those people weren’t paid enough, I’m sure, to bother.
As others have said, customer service doesn’t tell the whole story, but it’s sure noticeable, and it doesn’t follow the accepted storyline of private sector=efficient, public sector=not. Last time I had to go to the MVA to correct a problem with my license, I stood in line for 15 minutes to deal with a friendly, jovial employee who solved my problem in another 10 or so.
August 14th, 2008 at 12:48 pm
” I can’t wait for the government to take over our healthcare system.”
Given that the US is the oldest modern experiment in self-government this snark could be translated as:
“I can’t wait for the American people to take over our healthcare system. The American people screw everything up. America sucks. How do you like my flag pin?”
August 14th, 2008 at 12:58 pm
Well if the government ran the AirForce we would have huge amounts of waste, which we do. We would have technological progress only through huge cost overruns, which we do. The only argument for having the Air Force run by the government is that we don’t want something which could physically threaten the government as powerfully as the Air Force to be in private hands.
August 14th, 2008 at 3:00 pm
“The government’s taken over our national monetary policy — mistakes can plunge the country into recession or a destructive cycle of inflation.”
As they did during the inflation of the 1970’s. As they did when the engaged in deflationary policy during the Depression. As many are arguing they are doing right now.
“But look — the government already runs a fleet of air craft carriers. ”
So … you are holding up our military as a model of efficiency? Have you seen their budget lately?
August 14th, 2008 at 3:41 pm
Another one of Matt’s incredibly ignorant “Duh!” posts.
This is what you get when you have a kid four years out of college with a degree in philosophy.
Didn’t they teach logic in the philosophy program at Harvard? Probably not. They probably consider that a math course and stay away in droves.
August 14th, 2008 at 4:15 pm
Megan’s a vegan, right?
‘Nuf said.
August 14th, 2008 at 4:31 pm
Other vegans: Coretta Scott King, Cesar Chavez, Dennis Kucinich.
August 14th, 2008 at 5:48 pm
rumor has it that the government runs nuclear subs that have enough nuclear missiles on them to destroy the world many times over. could it be true?
August 14th, 2008 at 5:56 pm
This is a good argument up to a point. However, one of the strange quirks of the conservative world view is that the military is not seen as part of the “Federal Gummit”, if you know what I mean. The military is seen as a sort of Americanized, more folksy version of an ancient warrior caste. Now top brass Generals … that’s another story. There are plenty of conservatives who will freely express their dislike of “the generals in Washington” while lionizing “the troops”. Thats one of the reasons I believe that General Wesley Clark wouldn’t do much to bolster the Dems’ credibility in military matters … at least not among rank-and-file conservatives. I seem to recall him being portrayed by Republicans as part of a generation of Clinton-appointed officers who were seen as little more than petty bureaucrats. What most non-theorist government-haters want is quality, by which they mean quality for them. It’s not good enough to show them that broadly speaking, an agency is effective. If they are hassled at the government office, then government is bad.
August 14th, 2008 at 6:23 pm
Other vegans? Hitler.
I invoked Godwin. I win the thread!
August 14th, 2008 at 8:50 pm
I don’t think you have to agree that the military IS an effective government agency to concede that conservatives rarely cite the military as an example of how government can’t do anything right … even though it is, by definition, government-run. The point is not just that government does plenty of things right, its that anti-government conservatives ignore or re-define the bits of government they like in order to win their larger argument that all government is bad.
August 15th, 2008 at 4:02 am
if you don’t make an easily acquired appointment at the DMV
you deserve what you get when you show up