On Sun, 14 Nov 2004 02:13:13 +0000 (GMT), "Dave Plowman (News)"
wrote:

In article ,
Andy Hall wrote:
With the exception of services such as defence, emergency services,
judiciary and others of that ilk, there is no need for government
involvement beyond making sure that there is directed funding for
those unable to make their own arrangements to be able to obtain them
- e.g. healthcare and education vouchers.

Why not privatize things like defence? After all, it's a major profit
maker for the private sector. Regardless of how efficient they are. And
they often aren't.

True, but it's normally something where the delivery has to be
co-ordinated on a national level for operational reasons in time of
conflict. That's why I also excluded emergency services. The
judiciary represents a method of maintaining a stable society -on an
distant basis, a part of democracy itself and so a special case.



Beyond that, I see no reason for national or local government to have
an involvement in delivery in areas like healthcare, education and
pretty much everything else.
All of these when government operated do a poor job of customer
service and are poor value for money for the user and the taxpayer who
is funding it.,

You'd have to define 'poor value' For the rich maybe. For the poor,
invaluable. And that's what a decent society should be about, IMHO.

I think that it's poor value if compare with hospitals and primary
care in other countries. If I want appointments for diagnosis and
treatment in the public sector I have to wait until it suits them and
then be expected to be grateful for what I get.

Diagnosis and management of common medical conditions is systemised
and made a subject of government policy. For example, the
government wants to measure, build statistics and decide on treatment
for blood lipid profile based on total cholesterol. This is not
considered medically that useful by most experts whereas LDL and HDL
levels are important as is their ratio.

That's one simple example, and I've found many more like it. The
whole thing takes on the characteristic of a system with national
standards and decision making and does not address individual need
properly. My main issue is with the inherent systemisation of it
all.

This is not an issue of the ability to pay, but of the government
operating a healthcare system in general.

I completely agree that a decent society should have a means of
providing healthcare for all, including the poor and vulnerable. I
was careful to say that.
In other words, everybody should receive "money" in the form of
vouchers or equivalent to spend on healthcare and on education.
Unfortunately I do think that some method of control is needed because
there will be peoplw who given money instead would spend it on other
things and not cover themselves.

Everybody should be provided with enough voucher cover to get at least
as good a service as they get today and probably better because of
there being more providers being encouraged into the sectors.

People wishing to top up their voucher with money or insurance because
they'd like a private hospital room or an appointment at a different
time or a more suitable school should be able to do so. As it is
today, to exercise choice in education I have to pay twice and for
healthcare three times.
I'm not saying that I mind contributing to the common good, simply
that I would like a choice on what I derive from that common good and
to actually get something in return for my payments.






--

..andy

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