Inherent dishonesty in Irish political discourse

Eliot Rosewater

I received two political leaflets in the post today; one from Sinn Fein and one from Fine Gael. I'd like to use them as an example of what I see as the inherent dishonesty in politics in Ireland. I propose some discussion points in the last paragraph, if you wish to cut to the chase. I'm sorry this is so long.


The Fine Gael leaflet contained an article on the public finances in which it is said "The Pension Fund has been raided to feed the banks". The article takes 2007 as its frame of reference, so it covers three years. Within those years public spending has amounted to about €150 billion, and the costs of the banks, say, €75 billion. So the correct terminology would have been "The Pension fund has been raided two thirds to feed the public service and one third to feed the banks." But because "raiding" the Pension fund in the name of Single Mothers doesn't have quite the same ring, the author engages in a little light deception.

The Sinn Fein article I will quote concerns a new hospital in my town, and the HSE's recent invitation for tenders to run the hospital for 10 years. "If they are prepared to pay out this amount of money [€50-60 million] so that a private operator can make a profit, why could they not employ the staff directly?" As anyone who has done any kind of elementary economics course will tell you, private operators are more cost effective at providing services, even when factoring in profit. Sinn Fein's reasoning, taken to its logical conclusion, would involve the State nationalising every industry. Why let Heinz make baked beans if the State could "employ the staff directly"?

The thing these articles have in common is a fundamentally dishonest approach to discussion, in which it is acceptable to engage in fallacious reasoning to further your side. On Boards.ie such claims would be tackled and addressed, because Boards.ie is ultimately an accountability based platform: one can't say ridiculous things and get away with it.

But to me it seems that every day - in newspapers, on the radio, on Frontline - people do say ridiculous things and do get away with it. They aren't challenged and, as a result, people are influenced by dishonest arguments.


So, is there anyway we can improve political debate in this country so that it is based on honesty, openness and relatively sensible reasoning? Can we make journalists, politicians and writers accountable for the little things they say? Or is such inherent dishonesty inevitable? Are Internet forums the only place where candidness can play a central role in discussion?

RDM_83 again

If private sector is so much better at providing services (health) explain to me why its cost so much to get decent cover in the USA?

fly_agaric

Eliot Rosewater wrote: »

The Fine Gael leaflet contained an article on the public finances in which it is said "The Pension Fund has been raided to feed the banks". The article takes 2007 as its frame of reference, so it covers three years. Within those years public spending has amounted to about €150 billion, and the costs of the banks, say, €75 billion. So the correct terminology would have been "The Pension fund has been raided two thirds to feed the public service and one third to feed the banks." But because "raiding" the Pension fund in the name of Single Mothers doesn't have quite the same ring, the author engages in a little light deception.

The Sinn Fein article I will quote concerns a new hospital in my town, and the HSE's recent invitation for tenders to run the hospital for 10 years. "If they are prepared to pay out this amount of money [€50-60 million] so that a private operator can make a profit, why could they not employ the staff directly?" As anyone who has done any kind of elementary economics course will tell you, private operators are more cost effective at providing services, even when factoring in profit. Sinn Fein's reasoning, taken to its logical conclusion, would involve the State nationalising every industry. Why let Heinz make baked beans if the State could "employ the staff directly"?

The thing these articles have in common is a fundamentally dishonest approach to discussion, in which it is acceptable to engage in fallacious reasoning to further your side. On Boards.ie such claims would be tackled and addressed, because Boards.ie is ultimately an accountability based platform: one can't say ridiculous things and get away with it.

But to me it seems that every day - in newspapers, on the radio, on Frontline - people do say ridiculous things and do get away with it. They aren't challenged and, as a result, people are influenced by dishonest arguments.


So, is there anyway we can improve political debate in this country so that it is based on honesty, openness and relatively sensible reasoning? Can we make journalists, politicians and writers accountable for the little things they say? Or is such inherent dishonesty inevitable? Are Internet forums the only place where candidness can play a central role in discussion?

I don't see what the point of this is in some ways. In the end doesn't your main problem with the two example statements come from your personal idealogical views conflicting with the content rather than any lies or distortions contained within them?

Anyway, I think if politicians, business people, lobby groups, journalists etc can benefit from lying about things they will do so. If lying doesn't benefit them they will not do it. If people are educated/sane enough to see the lies in the first place, and then are willing (or able) to hold the liars to account and punish them for it the amount of distortion will decrease. It is pretty simple really.

Nodin

Eliot Rosewater wrote: »

As anyone who has done any kind of elementary economics course will tell you, private operators are more cost effective at providing services, even when factoring in profit.

.......bit of a presumption, to put it mildly.

Eliot Rosewater

Okay, I didn't think I'd have to defend this, but I said it and I believe in accountability, so I will. Private enterprises are primarily interested in maximising efficiency, because the shareholders are the ones who lose out if, you know, the directors decide to get a €10,000 photo shoot. If they don't provide a reasonably good service at a reasonably good price their goods will no longer be purchased, the competition will take over and they will lose money.

Competition is one of the reasons laptop computers are constantly becoming cheaper.

Governments, on the other hand, are primarily motivated by votes, and given that the costs of any given scheme are diluted over 4 million taxpayers, and that the benefits are usually concentrated over a small group, they will tend to prioritise special interests, such as banks and trade unions. Hence why public servants are paid more than private workers: the public sector wage bill is paid for by 4 million people but less than half a million benefit. Reducing the wage bill by €1 billion wouldn't do much to gain the votes of the 4 million - their individual benefit is very small - whereas the smaller group loses a lot and, as such, will be more likely to base their vote on that one single issue. Moral of the story: cutting public sector pay will hurt you at the polls. Case in point: the refusal of the government to reduce old age pensions in line with the cost of living decreases.

Jackie Healy Rae is a very in-your-face example of public choice theory, but it pervades throughout.

As regards health, the issue in the States is different to that here. The tender for this hospital is very specific: the private operator will be under strict regulations. It will be in their interest to operate the hospital as cost-effectively as possible, but given said regulations, they will be unable to produce unsafe services. Given the importance of health services strict regulations like this are justified.


Finally, on a general public vs private note, we should be asking, if the government is the most efficient provider of services, as per the Sinn Fein leaflet, why was Cork City Council recently forced to sell its business? Surely not inefficiency!

Eliot Rosewater

fly_agaric wrote: »

I don't see what the point of this is in some ways. In the end doesn't your main problem with the two example statements come from your personal idealogical views...

I'm sorry, but that the cost of public services over the past 3 years is over double the cost of the bank bailouts is not something out of my "personal ideological views". It is a statistical fact.

djk1000

Eliot Rosewater wrote: »

The Fine Gael leaflet contained an article on the public finances in which it is said "The Pension Fund has been raided to feed the banks". The article takes 2007 as its frame of reference, so it covers three years. Within those years public spending has amounted to about €150 billion, and the costs of the banks, say, €75 billion. So the correct terminology would have been "The Pension fund has been raided two thirds to feed the public service and one third to feed the banks." But because "raiding" the Pension fund in the name of Single Mothers doesn't have quite the same ring, the author engages in a little light deception.

But without the bank issue, public services would still have cost €150 billion and the pension fund wouldn't have been raided, in fact 1% of the tax take each year would have been added to it.
I think it is quite fair then to say that the pension fund was raided to bail out the banks, particularly when legislation was passed specifically to make pension fund money available to recapitalise Irish banks.
I would also point out that the pension fund now has shares in the banks which may have an upside in the future.

I understand the argument you are making and I would tend to agree, but your examples invite argument and this thread is enevitably going to wind its way down to a public vs private fight and a lock.

Eliot Rosewater

djk1000 wrote: »

But without the bank issue, public services would still have cost €150 billion and the pension fund wouldn't have been raided,

Equally, if public services had been reduced by €25 billion then the pension fund wouldn't have been "raided" either. At the end of the day the government has spent €225 billion altogether, and there's no reason to say that one item of spending or another was specifically responsible for the "raid". And it's not as if FG we're proposing a laizze-faire approach, either.

djk1000 wrote: »

I understand the argument you are making and I would tend to agree, but your examples invite argument

Indeed, I was a little too rash in starting the thread. It's been in my head for a while, and when I read those two leaflets over dinner I decided to start a discussion about it. Perhaps I'll find some better examples sometime.

It's a pity really, because I'm very interested in good debate, and how one can facilitate good debate. However it seems that the core issue of this thread won't actually be discussed here. I'm partly to blame, it seems.

southsiderosie

Eliot Rosewater wrote: »

Okay, I didn't think I'd have to defend this, but I said it and I believe in accountability, so I will. Private enterprises are primarily interested in maximising efficiency, because the shareholders are the ones who lose out if, you know, the directors decide to get a €10,000 photo shoot. If they don't provide a reasonably good service at a reasonably good price their goods will no longer be purchased, the competition will take over and they will lose money.

Eliot Rosewater wrote: »

The thing these articles have in common is a fundamentally dishonest approach to discussion, in which it is acceptable to engage in fallacious reasoning to further your side. On Boards.ie such claims would be tackled and addressed, because Boards.ie is ultimately an accountability based platform: one can't say ridiculous things and get away with it.

I wouldn't disagree that there is a lot of silliness on the radio and in newspapers. And I think that political debate can be improved.

However, I see a fundamental flaw in where you are coming from in this argument, and I will use the Sinn Fein flyer to make my point. You call it "fallecious reasoning" and "fundamentally dishonest" that Sinn Fein would want people who provide public services to be public sector employees, and your reason for this is that it is not efficiency-maximizing. But not only is is a contestable notion that the private sector is always more efficient, you seem to be assuming that the interest of policymakers should be maximizing efficiency. Its not. Parties are out to maximize votes, and Sinn Fein knows its base. I could see where you were coming from if you had received this flyer from the PDs, but, Sinn Fein? This is an absolutely honest response from them because they see other issues in play besides efficiency (and to be fair to them, I think this goes beyond electoral pandering as well), even if you don't.

Scofflaw

RDM_83 again wrote: »

If private sector is so much better at providing services (health) explain to me why its cost so much to get decent cover in the USA?

Essentially, because health insurance is a very imperfect market. By that I don't mean that it has loads of cartels or corruption, I mean that it suffers from a sort of logical problem.

That logical problems are that:
(a) healthy peoples' premiums are what pays for sick peoples' treatment;
(b) the cost of the premiums must be lower than the cost of care for each individual; and;
(c) the way you make profit is by taking in more in premiums than you pay out in cover.

Therefore, the way you can make the most profit and offer the lowest premium is to sell your insurance to healthy people, and because they're healthy, you don't need to offer them much, because they know they don't need much, and they won't use it much anyway. So the most profitable insurance company is one that only sells to the young/healthy market.

Now, since it's an open market, anyone who is actually healthy will go with the low-premium, low-cover insurance providers. That leaves the rest of the people - who aren't healthy, and who actually need decent cover. Their providers have to charge them bigger premiums, though, because they're actually going to use the cover - and you don't have healthy people's premiums to cover them, because they've gone to the low-premium low-cover providers.

The result is a market in which contracts are written with a million and one trip clauses to prevent the unhealthy getting insurance intended for the unhealthy, and in which insurance is only very slightly lower than the cost of providing the healthcare - only, in fact, by the extent to which people are either more neurotic about their health than they need to be, and are unable to come up with large sums of money at short notice.

Some markets are like that - left to themselves, they provide a sub-optimal solution, at least from the perspective of customers and the economy at large, due to the nature of the market itself rather than by collusion or fraud. Free markets work well for some things, but not all things.

cordially,
Scofflaw

Lockstep

Scofflaw wrote: »

Free markets work well for some things, but not all things.

Excellent post, the quoted bit sums it up extremely well.

I doubt many people want the government to get involved in things like the production of Skittles or cars, but healthcare and education aren't things I can comfortably leave to the private sector alone.

Laminations

Eliot Rosewater wrote: »

I'm sorry, but that the cost of public services over the past 3 years is over double the cost of the bank bailouts is not something out of my "personal ideological views". It is a statistical fact.

While I agree with you that public expenditure is a huge issue, the amount of money being spent is a separate issue to the target that the money is going. Public money should be spent on public services, that is the correct target even if there is huge overspend. Public money should never be pumped into banks, I'd presume as a libertarian you'd agree, hence the anger. There is precedent for governments running efficient services with tax payers money, just because we don't do it here doesn't mean the concept of having a government is wrong

ei.sdraob

Scofflaw wrote: »

Some markets are like that - left to themselves, they provide a sub-optimal solution, at least from the perspective of customers and the economy at large, due to the nature of the market itself rather than by collusion or fraud. Free markets work well for some things, but not all things.

cordially,
Scofflaw

And there I disagree with you

You say that the market provides a sub optimal solution when it comes to healthcare
yet a public health care has identical and in some cases larger costs.
this cost is spread via taxation onto productive people/companies putting them at a disadvantage.
its all optics and illusion, someone somewhere ends up paying for it, making healthcare public does not make the large costs go away, if anything it opens a window for waste to creep in.
shifting the problem elsewhere does not solve a problem.



To give an example that you would be familiar and argue alot about when comes to carbon taxation, the problem of pollution.
By dumping stuff into environment the problem is dumped/spread among everyone in the system. You in this case argue for taxation (polluter pays principle) in order for the entity responsible for pollution to be pay the costs.

Yet somehow it is wrong to ask people responsible for higher costs to pay for the bill they run up when it comes to healtcare and its ok to spread their costs among the whole population?

Laminations

ei.sdraob wrote: »

To give an example that you would be familiar and argue alot about when comes to carbon taxation, the problem of pollution.
By dumping stuff into environment the problem is dumped/spread among everyone in the system. You in this case argue for taxation (polluter pays principle) in order for the entity responsible for pollution to be pay the costs.

Yet somehow it is wrong to ask people responsible for higher costs to pay for the bill they run up when it comes to healtcare and its ok to spread their costs among the whole population?

People have a choice whether to pollute or not. They don't have a choice about getting sick and if they are poor or lower income they are more likely to be getting sick more. Likewise people don't choose their parents or their genes or intelligence etc so there is a role for the state to regulate (something you agree with) through progressive taxation and provision of good services to provide a more even playing field for competition so someone born with a disadvantage can be given the opportunity to compete with someone born with a silver spoon in their mouths.

The problem is the bit in bold but sure that'll improve through Market forces acting within the political sphere

Yitzhak Rabin

ei.sdraob wrote: »

Yet somehow it is wrong to ask people responsible for higher costs to pay for the bill they run up when it comes to healtcare and its ok to spread their costs among the whole population?

Its because most people see healthcare as a fundamental right, that should be dispensed by peoples needs, rather than their ability to pay.

People advocate public healthcare, not because they think it is the cheapest, or most efficient way, but because they believe it is the fairest way.

Boskowski

There is one obvious flaw in what you are insinuating. You are insinuating that that both amounts, one spent on public service and the other one spent on banks, are black holes and offer no return. You forget that while public service is bloated, mismanaged and wasteful it still provided services over the last three years. It built roads, it ran hospitals, it kept people afloat with welfare payments, it provided jobs. What does the bank bailout give us I don't know. You will find people arguing it saved the country but quite frankly nobody really knows. Had we not given the garantees and the NAMA and whatnot I'm sure nobody would have starved or died even and while it may have been spectacular for a little while things would have been back to normal fairly swiftly. My point is that we got nothing for that money but some dubious and foggy 'it saved the country'. We certainly never gonna see any of the money that went to the banks directly and the NAMA money - well I'd be surprised if after 'fees' and interest we'd even see 25% of that 'discounted' loan money back.

It was the biggest and at the same time most public robbery in history. You must have a fairly big agenda if you try to construe how the banks thing was an equally fair cause for spending the pension money.

And it isn't the public service's fault either that they are bloated and mismanaged and wasteful. It's their nature. The fault is with corrupt in incompetent administrations and an immature electorate who fails to see the political players for what they are.

Nijmegen

All arguments, political, commercial, marketing, whatever... Are two or more sides arguing the same ground, seeing things slightly or dramaticly differently, and trying to persuade others of the same.

I think when you see political or other marketing literature you should join the majority of people who treat it with a grain of salt.

Most people trust their friends and family to help them form opinions, not marketing.

Laminations

My girlfriend was quite angry when I spent €100 on groceries from Dunnes when I could've gotten the same in Lidl for half the price - thats value for money anger, and she is of course right.

She however then went ballistic, completely raging when I just burnt €20 in front of her? Why was she more angry, it was far less money???

Is that the extent of logic in the OP?

dan_d

No. I think what the OP is trying to say is that journalists, politicians, the media, spin doctors, whatever...take facts and twist them to their own gains, by not telling the whole truth - by highlighting the facts that back up their arguments or points.

It's vaguely similar to a programme I saw a while ago regarding EU food standards and the type of indication that had to be given on food packaging. I can't remember the exact argument but the point was being made that if the EU approved a watered-down version of whatever it was looking at regarding labels on food, the following situation would be created. Take a chocolate cake. Ingredients:flour, butter (lots), sugar, eggs, milk/water, whatever else...there's calcium in butter. There's protein in eggs. So the cake manufacturers would be able to put on the packet "source of protein and calcium"...omitting the fact that it's a bigger source of saturated fat and it's protein and calcium contents are negligible. But they could twist the facts to make it sound like a supremely healthy source of these things.

I know that's a bit of a ramble but I think that's what the OP was saying. Too many people in this country, with arguments to peddle, take a fact cherry-pick what suits them and then scream it out across the airwaves repeatedly. The same is done with statistics. We rarely get the full story. The yearly education debate about league tables....100% of an LC class in a private school went to college. Only 50% of the public school down the road went. It's disgraceful, we should have tables so people can see results, and know what school is good. What's omitted from the headline, and only printed in the fine print on the table (which few people read) is that there were 80 kids in the private school LC class and 200 in the public school LC class....therefore, 80 went to college from the private and, in fact, 100 went from the public school.

Things are frequently said out of context and accepted.

Is that the gist of what you trying to say OP, or have I totally missed the point?!

ei.sdraob

yekahs wrote: »

Its because most people see healthcare as a fundamental right, that should be dispensed by peoples needs, rather than their ability to pay.

People advocate public healthcare, not because they think it is the cheapest, or most efficient way, but because they believe it is the fairest way.

A sense of entitlement that will push alot of economies over the edge,

We already have jobs going to places like China (who despite being communist in name) do not provide free healthcare and leave it to the people to save up for own healthcare and for families to help each other.

Once again public healthcare does not try to address the underlying issues of high cost, costs are being brought down by private competition developing cheaper drugs and providing cheaper/better personnel and equipment.

A solution I believe lies somewhere between public and private healthcare, with insurance and investment in anything that would cut costs and lead to better efficiency.

So once again I call bull**** on @Scofflaw's post, market forces are alive and thriving in healthcare too

Its competition between medical device makers for example (plenty here in Galway) that is leading to better and cheaper products (I have relative who researches and develop these new products). It is the market competition that is bringing in generic drug replacements lowering the costs for HSE.
It is happening, slowly but it is happening, there was an interesting Horizon episode on human genetics and developments of new treatments for the likes of cancer where private and publicly/charity founded labs where competing and collaborating on making new treatments which will lower costs and save lives.

The market is alive an present and is actively cutting healthcare costs. While all public healtcare does is spread the cost and provide a fertile ground for superbugs superwasters to breed

Laminations

Everyone does that, i.e. present information that backs up their argument. I think FF are rubbish and a scourge to this country, however I do recognise they have done some good things but I'm not going to advance my argument by listing out all these good things every time I want to mention yet another bad thing they've done.

Of course context is important, I think Eliot has misunderstood the context of public anger into which opposition politicians are trying to tap. Its not simply the amount of money being spent/wasted - its the appropriateness of giving money to banks, and the perceived payback as yekahs and boskowshi have also said.

Laminations

ei.sdraob wrote: »

So once again I call bull**** on @Scofflaw's post, market forces are alive and thriving in healthcare too

Its competition between medical device makers for example (plenty here in Galway) that is leading to better and cheaper products (I have relative who researches and develop these new products). It is the market competition that is bringing in generic drug replacements lowering the costs for HSE.
It is happening, slowly but it is happening, there was an interesting Horizon episode on human genetics and developments of new treatments for the likes of cancer where private and publicly/charity founded labs where competing and collaborating on making new treatments which will lower costs and save lives.

The market is alive an present and is actively cutting healthcare costs. While all public healtcare does is spread the cost and provide a fertile ground for superbugs superwasters to breed

But with healthcare, humans are the product, not like medical devices or drugs in the associated private competing sectores. If humans are the product and the cost then healthy humans will be cheaper than sick humans and old and poor people are more likely to be sick so will most likely be more expensive, no amount of competition will change that

Just look at BUPA, given the chance they would have cherry picked all the young healthy people out, making it great from them with cheap insurance until they got old and infirm or lost their job in which case they'd be dropped and other private health enterprises would bleed them dry.

southsiderosie

ei.sdraob wrote: »

A sense of entitlement that will push alot of economies over the edge,

We already have jobs going to places like China (who despite being communist in name) do not provide free healthcare and leave it to the people to save up for own healthcare and for families to help each other.

Once again public healthcare does not try to address the underlying issues of high cost, costs are being brought down by private competition developing cheaper drugs and providing cheaper/better personnel and equipment.

A solution I believe lies somewhere between public and private healthcare, with insurance and investment in anything that would cut costs and lead to better efficiency.

So once again I call bull**** on @Scofflaw's post, market forces are alive and thriving in healthcare too

Its competition between medical device makers for example (plenty here in Galway) that is leading to better and cheaper products (I have relative who researches and develop these new products). It is the market competition that is bringing in generic drug replacements lowering the costs for HSE.
It is happening, slowly but it is happening, there was an interesting Horizon episode on human genetics and developments of new treatments for the likes of cancer where private and publicly/charity founded labs where competing and collaborating on making new treatments which will lower costs and save lives.

The market is alive an present and is actively cutting healthcare costs. While all public healtcare does is spread the cost and provide a fertile ground for superbugs superwasters to breed

Innovation is making drugs and supplies cheaper. Yet the costs of healthcare are actually going UP.

I totally agree with Scofflaw's post on this matter, and I think Chris Rock said it best when he noted "The money's not in the cure, it's in the treatment". In health care systems when the focus is on primary care, keeping people healthy, and not bundling everyone off to expensive specialists or pumping them full of drugs, it is possible to provide good public health services. And private clinics can come in to compete if people don't want to wait a month for an appointment. However, when profit is the primary motive, drugs, tests, specialists, and generally wasteful procedures are rampant, largely because every transaction brings in more money.

I also think that telling people in wealthy countries that they should just save for health care is unreasonable. I do think that people should pay some of the cost of doctors visits, drugs, etc. But cancer treatment can cost as much as a house (and people who get cancer in the US who don't have insurance often end up losing their homes).

In addition, again, efficiency is not the only factor that matters here. Public health outcomes are, frankly, more important. And I see no correlation between market-driven systems and better public health statistics. And that end goal seems to get lost in a lot of the debate around privatization.

I have yet to see convincing evidence that totally market-drive health care systems 1) are better at controlling costs than public systems, and 2) have better outcomes for public health. And to bring it back to the OP, civil society groups and political parties who question a market-driven system should not be dismissed out of hand as being disingenuous or twisting the facts; the underlying assumptions of their arguments are completely different.

ei.sdraob

I realise the thread is drifting, but its very interesting discussion on healtcare.

@Laminations and southsiderosie you are both missing the bigger picture.
and are not asking the why question

why are healthcare costs rising?

* people are living longer and population is getting older
* most of the healthcare costs (here in Ireland anyways) are spent on wages
* patent laws etc are preventing cheeper/better drugs from arriving on market
* long trial times coupled with lawyers willing to sue anything that moves makes companies take a loooong time to bring solutions to problems to the market
* lack of competition in insurance area

do you agree with above observations?

likes of Laminations point around and say the market has failed, so lets give up and join hands together and sing in a happy socialist utopia, his analysis is shallow.

I already said that the solution will lie with a mix of a public/private insurance scheme, not in a pure state only healthcare solution.


I pointed out the major issues in healthcare that drive up the costs. State healthcare does not address any single one of these issues, while the market is addressing some of these and trying to drive costs down, but ironically the state prevents some of these costs from being addressed, for example:
* how do you reduce wages of public employees? yep you cant as our Croke Park adventure has shown, they are very unwilling to face cuts, while private counterparts in hospitals can and do get wage cuts or made redundant if they are incompetent for that matter.
* our education system prevents more people from going into healthcare
* our state has wasted so much money on banks and public wages that they have to close hospitals

@Laminations you keep saying that the market has failed blah blah, but when you dig deeper and look at the root causes of each failure you see the hand of the state being responsible.

ei.sdraob

Laminations wrote: »

But with healthcare, humans are the product, not like medical devices or drugs in the associated private competing sectores. If humans are the product and the cost then healthy humans will be cheaper than sick humans and old and poor people are more likely to be sick so will most likely be more expensive, no amount of competition will change that

Just look at BUPA, given the chance they would have cherry picked all the young healthy people out, making it great from them with cheap insurance until they got old and infirm or lost their job in which case they'd be dropped and other private health enterprises would bleed them dry.

That is not failure of the market @Laminations

If some people cant get healthcare that is because there is no market for their cases. Yes i know it might sound cruel but it has to be said.

Now the solution exists and I already mentioned this earlier in thread. There was no market for polluting the environment, but now we have a carbon trade market. Something similar could be done with healthcare where the state becomes insurer of last resort for people for whom the market can not accommodate and price an insurance risk.

The question then becomes what level of support does a government open, and more importantly how can it facilitate competition, the last thing that is needed is a government becoming a monopoly on healthcare insurance/provision (As you know monopolies whether public or private are bad for everyone.), driving out all private competition and resulting in stagnation and waste, with the root cause of high healthcare being high costs we need to drive costs down via competition. Having a state monopoly on healthcare will not in any way solve the issues involved and lower costs, if anything the costs would mount as we seen in this country.

That goes back to my earlier posts, the solution will lie in a mixture of public and private healthcare insurance and provision. But competition has to be encouraged and monopolies/cartels with their resultant waste avoided at all costs.

the dutch model comes close to what is desired. but of course it would have to be tweaked for Ireland


edit: @OP sorry once again for the thread drifting, maybe this can be split off

southsiderosie

ei.sdraob wrote: »

That is not failure of the market @Laminations

If some people cant get healthcare that is because there is no market for their cases. Yes i know it might sound cruel but it has to be said.

Now the solution exists and I already mentioned this earlier in thread. There was no market for polluting the environment, but now we have a carbon trade market. Something similar could be done with healthcare where the state becomes insurer of last resort for people for whom the market can not accommodate and price an insurance risk.[/B}

So the public has to pay for all of the complicated expensive cases, while the private sector gets to profit from making healthy people pay for insurance that they probably won't need and dumping them onto the public sector when they get too old or sick?

Also, on this "there is no market for their cases" business, frankly I think that is a sickening way of looking at health care. Nobody knows if they are going to develop cancer or Parkinson's or diabetes, and we should not make these people suffer if they do.

ei.sdraob

southsiderosie wrote: »

So the public has to pay for all of the complicated expensive cases, while the private sector gets to profit from making healthy people pay for insurance that they probably won't need and dumping them onto the public sector when they get too old or sick?
.

The alternatives are either paying for all healthcare or paying for no healthcare.
This is a middle ground and it tries to address the root issues of high healthcare costs.

You missed the main point of my posts unfortunately . In this type of system competition still exists (And should be encouraged in any way possible), with both private and public sector being involved, competition drives costs down. In a completely public system there is no incentive to drive costs down, for example by lowering wages or replacing employees who are under-performing. You instead end-up with tragic cases where whole wards are closed in hospitals while consultants and staff drive around in nice german cars....

southsiderosie wrote: »

Also, on this "there is no market for their cases" business, frankly I think that is a sickening way of looking at health care.

It is reality, putting spuds in ears and singing lalala doesn't make it go away. Unlike others on this thread I have pointed out the root issues and proposed a solution.
In software engineering you approach a problem by breaking it down into component issues and try to find root causes, by addressing the root causes you design for and solve the main problem.
I have tried to identify the issues and proposed a solution, now you go.

southsiderosie wrote: »

Nobody knows if they are going to develop cancer or Parkinson's or diabetes, and we should not make these people suffer if they do.

A completely public system doesn't even attempt to find cures for these diseases, neither is there an incentive to do so. There is no drive to reduce costs for that matter there is a lot of friction.

As I said there was a interesting BBC documentary few nights ago about the genome, there is great work being done with private companies and university/charity laboratories working together and competing in finding all sorts of cures based on the human genome, some of these are being targeted towards certain cancers. That is marvellous work being done there.

Eliot Rosewater

Scofflaw wrote: »

Essentially, because health insurance is a very imperfect market. By that I don't mean that it has loads of cartels or corruption, I mean that it suffers from a sort of logical problem.

I appreciate the post, but in the mad rush to grab the pitchforks and light the brands we've forgotten one thing: the issue of one hospital being operated by a private company is completely and totally different to the considerations of a fully privatised insurance-based health system.

I thought people would have realized this.

southsiderosie wrote: »

... you seem to be assuming that the interest of policymakers should be maximizing efficiency.

But Sinn Fein's argument, that I quoted, was that it should be run by the HSE because they claim the HSE would be more efficient. So my assumption is actually Sinn Fein's assumption.

If they had argued it for other reasons (for example, the need to ensure universal access) I might have agreed, but because they argued it on the basis of efficiency, I found the argument dishonest.

Eliot Rosewater

Laminations wrote: »

Is that the extent of logic in the OP?

No. The extent of logic is this. Suppose the combined amount you mentioned (€120) was partly taken out on an overdraft of, say, €20. When you go to pay the overdraft your girlfriend might say "you're raiding our account to burn money". However, it would be equally correct to say "you're raiding our account to shop in Dunnes". In fact, given that the shopping costs 5 time the amount of the burning, the latter might even be more correct.

The issue of value for money, which you mentioned, is merely a red herring. Within the context of this discussion it doesn't matter what benifits we get out of the pension fund "raid". The only relevent fact is that the fund was "raided".

Laminations wrote: »

...I'd presume as a libertarian you'd agree...

I'm perfectly able to articulate my own views and, as a matter of fact, I know a lot more about them than you do. So I'd appreciate it if you stopped trying to pigeonhole me into a single 11-letter word. The only reason I mention it is that this isn't the first time it's happened, and it's not conductive to a good debate. Thanks.

Denerick

I have to agree with the OP, even if I disagree with his optimism regarding the efficiency of the free market (Profit maximisation can just as easily lead to sloppy standards as government inefficiency - at least the government is under no pressure to make a profit but instead provide a universal human service) The standard of political debate in this country is very dishonest, and ordinary voters by and large are responsible for this themselves. The more we lap up the absolute nonsense from FG and Labour RE the public spending binge during the boom, the more we willingly choose to delude ourselves. We need to accept that there was a political consensus during the Tiger economy, and that every Tom Dick and Harry in the big three would have followed substantially the same policy, with roughly the same results.

Essexboy

Eliot Rosewater wrote: »

Okay, I didn't think I'd have to defend this, but I said it and I believe in accountability, so I will. Private enterprises are primarily interested in maximising efficiency, because the shareholders are the ones who lose out if, you know, the directors decide to get a €10,000 photo shoot. If they don't provide a reasonably good service at a reasonably good price their goods will no longer be purchased, the competition will take over and they will lose money.

Competition is one of the reasons laptop computers are constantly becoming cheaper.

Governments, on the other hand, are primarily motivated by votes, and given that the costs of any given scheme are diluted over 4 million taxpayers, and that the benefits are usually concentrated over a small group, they will tend to prioritise special interests, such as banks and trade unions. Hence why public servants are paid more than private workers: the public sector wage bill is paid for by 4 million people but less than half a million benefit. Reducing the wage bill by €1 billion wouldn't do much to gain the votes of the 4 million - their individual benefit is very small - whereas the smaller group loses a lot and, as such, will be more likely to base their vote on that one single issue. Moral of the story: cutting public sector pay will hurt you at the polls. Case in point: the refusal of the government to reduce old age pensions in line with the cost of living decreases.

Jackie Healy Rae is a very in-your-face example of public choice theory, but it pervades throughout.

As regards health, the issue in the States is different to that here. The tender for this hospital is very specific: the private operator will be under strict regulations. It will be in their interest to operate the hospital as cost-effectively as possible, but given said regulations, they will be unable to produce unsafe services. Given the importance of health services strict regulations like this are justified.


Finally, on a general public vs private note, we should be asking, if the government is the most efficient provider of services, as per the Sinn Fein leaflet, why was Cork City Council recently forced to sell its business? Surely not inefficiency!

Where is the private sector superiority here?

The former twenty-four staff members of Sligo's private hospital, St Josephs have been advised by hospital management that more time is required is finalise the outstanding redundancy arrangements and payments due to them.

The former employees have waited for over eighteen months to have the balance of their severance packages paid to them.

It is understood that management deferred outlining the solution until another meeting arranged for Friday 12 November.
http://www.sligotoday.ie/details.php?id=11418&PHPSESSID=f79f44ccb4ec8534e57cf3c7d208546b

The hospital is part of the Mount Carmel group.