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A government takeover of healthcare would affect more than availability of care. It would affect how healthcare providers respond to meet consumer expectations.
While standing in line yesterday waiting to reach the counter at the City of Dallas Water Utilities Department, I imagined that this must be comparable to standing in line at a Soviet Bloc government distribution center.
Depression hung in the air. The room was a canyon of concrete, (and not polished and colored, not the fancy kind you find decorating floors in upscale restaurants). No, this was the proto-stuff the Romans invented and probably finished with forced labor and horse-hair brushes. It has an almost universally depressive effect on the human spirit. A person just can’t look at this stuff and be happy.
I was standing there, in a cavern of concrete, because no one at the government provided water department answers the telephone; they don’t have to. There is only one place to get running water, and the government provides it at or below cost. This is both good and bad.
The government workers behind the desk were kind, and far from unpleasant. But I really can’t say that they seemed too worried about losing their jobs if the customers were upset; either from the pace of government services being offered, or from the concrete. They knew what I knew, there is nowhere else to buy running water. Nor did the workers seem to worry about such silliness as customer service or holiday cheer.
It reminded me of a report I saw on Fox News last month, children at Grace Academy in Prosper, Texas, spent most of one Friday making homemade Christmas cards for bedridden veterans at the VA hospital in Dallas.
The story relates how fourth-grader Gracie Brown was especially proud of her card, hoping it would make their day because their family might live far away, and they might not have somebody to celebrate Christmas with. She told MyFoxDFW.com, “I’d like [Veterans] to know they’ve not been forgotten and somebody wanted to say thank you.”
There was just one problem: The VA Hospital does not, um ... permit ... Christmas cards. A VA spokesperson told Fox News (and this is a quote from the Veterans Health Administration handbook): "In order to be respectful of our veterans' religious beliefs, all donated holiday cards are reviewed by a multi-disciplinary team of staff led by chaplaincy services and determined if they are appropriate (non-religious) to freely distribute to patients."
Hiram Sasser, the director of litigation for Liberty Institute, was quoted by Fox News (at this point I was reading between my fingers as I had planted my face in my palm) as holding the opinion that this was a new low “even for the Scrooges and Grinches at the VA ... do the Grinches in the administration of the VA really believe our bravest warriors need protection from the heartfelt well wishes of small children saying, 'Merry Christmas'?”
I don’t want to get off on a constitutional discussion here, as I am fairly certain government employees are not permitted to confirm or deny the existence of “Scrooge” or “Grinches,” let alone speculate how many might constitutionally dance on the head of a pin. I would rather stick to the subject of government provision of services vs. the private sector.
A private-sector hospital wouldn’t stay in business very long if it appointed a “multi-disciplinary team of staff” to review the threat level of children’s Christmas cards. The public would take their business elsewhere. But the VA knows what the water department knows: veterans don’t have anywhere else to go. Therefore the VA staff naturally isn’t thinking the way a private sector hospital always would: “What do we need to do to meet patient expectations? How can we better serve the patient?”
This illustrates a point conservatives have been making throughout history. When government steps in to provide a service, it displaces a private sector business. More subtly, the government isn’t motivated by competition to meet consumer expectations; there isn’t any competition.
Why is this important? Many fear the Affordable Care Act (ACA) is but one step toward a government takeover of healthcare. This fear is usually expressed in concern over rationing and long waiting lists.
But there is also a human element, like Christmas cards from children, which doesn’t show up on a balance sheet. There is also a reason profit motive and competition in an economic system provides the best service.
Profit motive brings out the best in people. It encourages people to strive, to achieve, and to develop better ways of doing things which improve the human condition. It is fair to say lack of profit motive does the opposite, as we saw in the old Soviet Bloc countries where formerly for-profit workers became passive aggressive saboteurs. Social service tends to take the joy out of the delivery of everything from water to healthcare.
That’s just human nature, and it is something to think about, if the ACA’s critics are even partially correct in predicting a government takeover of healthcare.