Skip to main content

View Diary: The $ilver Lining in the ACA Plan (15 comments)

Comment Preferences

  •  Good points. (2+ / 0-)
    Recommended by:
    jfromga, Words In Action

    Let me add, for starters, that while I am generally cool to the role of middlemen, who merely take a cut from any transaction between a producer and user of a good or service, mostly by manipulating the marketing, middlemen actually have a useful function when we are discussing DISUTILITIES. Disutilities are "goods and services" which the recipient would rather not have (and is thus disinclined to purchase), but needs to stay alive. This need not only makes the recipient incautious about cost, but it puts him at a distinct disadvantage in his relationship with the provider. Which means there is a definite role for a mediator or middleman to help determine whether the identified need is going to be appropriately met. Indeed, that's why we set up public corporations, to act as mediators on our behalf. That private entities are eager to participate as middlemen should not come as a surprise because, not only is meddling their normal enterprise, but the capitve market is almost irresistable to them. Private enterprise is always covetous of access to the public purse, if only because the purse is public.

    What is still in dispute is the extent to which private access to the public purse should be regulated or restrained, especially when need is driving the agenda. That a profit margin of 15% should be set in the provision of military hardware and services has been a long-standing criterion.  It hasn't worked all that well because, unlike what we expect from the provision of medical services, the recipients of national defense goods and services are not in a position to provide feedback as to its usefulness or approrpriateness. Not to mention that the guaranteed profit margin operates in an environment where the base is essentially unconstrained. Delivery delays and even quality flaws are not devastating (unarmoured vehicles in Iraq were an exception).

    In short (haha), what we expect from private insurers is that like the public insurer (Medicare & Medicaid), they will exercise some quality control on behalf of people in need of medical care. That's what they are going to get paid for. And the recipients of care, if they survive as expected, will, in the long run, be in a position to provide feed-back as to the quality and value. And what the Congress has (wisely) recognized is that moving 50 million citizens into a new program is too complex to be handled in a timely manner, unless some of the traditional players continue to play a part.
    Also, since insurance companies have recently been somewhat disillusioned by the collapse engineered by their friends at the banks, a smaller guaranteed profit margin probably looks better than what they got from contributing to the speculative pot.

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site