this is extra fun when you have a newborn and you never get the same person twice and each time you call the person you get tells you a different thing about what your policy covers and no one ever takes any notes (and it is all intentionally done this way)
I just had to spend two goddamn hours explaining to them that my thirty-day supply of meds should be filled every thirty days. Not the same day every month.
As someone who works in insurance: this is 100% correct. The amount of clean-up I've had to do due to inefficiency (or people just not caring about clients) is unreal.
Private companies are answerable only to their stockholders and their only goal is maximizing shareholder profit. Why would anyone think that is better than a government answerable to the people?
Every large company I've worked in wastes so much money internally on the most frivolous initiatives and misguided goals. Each having way more levels of redundancy and bureaucracy than any government office, except perhaps the DOD. People literally just wade between reorgs.
Any time I hear this claim I tell that person my Vivent Solar story. Also, just last week, the IRS solved a problem for me in under 30 minutes. Also also, I have worked for the feds and currently work for a private company and lololololololol. Efficient?
1000%
1. Pharmaceuticals
2. health Insurance
3. Health care providers
4. Airlines
5. Private contractors operating water/WWTPs
6. Agribusiness
And the list goes on of businesses that need to be broken up or seriously regulated.
Citizens United really fucked us!
Not that government bureaucrats are much better, but yes.
βInsuranceβ is both a scam and a predatory industry in general, especially in regards to healthcare.
Weβd be much better off getting rid of the private companies and instituting a government funded universal health care program.
My insurance company (which left me on the hook for $3000 of hospital bills last year) helped me to save $800 on an MRI recently, so that was nice of them I guess
Inefficiency is capitalism's most successful extractive technology.
The more time and effort that can be wasted on the way to accomplishing a given end, the more time and effort can be billed, monetized, underwritten, subsidized, and resold to the highest bidder.
Or cable companies, or phone companies, or electric companies, or Amazon or Walmart or Microsoft or Google. Or damned any large corporate entity. We feel like we spend most days waiting in long, indifferent Soviet Union-style lines for some inadequate, scarce and crappy service or product.
pretty sure the only way a for profit can do something cheaper than a non-commercial entity is: Paying labour less than they should, cutting corners where they shouldn't like safety, quality, environment, etc.
it costs society in the long run...
Also true on the back end. I've worked for multiple massive media conglomerates: Warner/Turner, Netflix, NBC/Universal, Fox/News Corp. in all instances the communication between departments was glacially slow, and policies onerous and counter productive. Minus netflix, all had pre-1994 paperwork.
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Most government departments (in my experience at least) have a budget they need to get rid of so they aren't incentivised to price gouge and save money.
Or taken a Greyhound. Whenever there's talk of nationalizing intercity busses, people say the service would get worse and I honestly don't think that's possible.
The government is mostly efficient because it's already eliminated most of the options via policies, regulations and exclusive contracts...and so have insurance companies?
North Carolina finally adopted the Obamacare Medicaid expansion, and of *course* it's administered by private health insurance companies, for no good reason.
The thing is, the government's incentive is providing a service good enough to keep them elected. The private company's incentive is getting the most money possible for the minimum service possible to maximize profits. Of course it's gonna be bad, because such is the nature of capitalism
Efficiency: the ratio of what you get out of a system compared to what you put in.
US healthcare efficiency: Delivers shorter life expectancy and lower quality of life whilst spending roughly 150% of other advanced economies. Oh, and very wealthy shareholders.
Where does the money go?
Vote.
We might be in a lot less trouble if more people ever stopped to ask themselves just who all this worship of "efficiency" is in service of, and whether cheap trinkets and free 48 hour delivery are worth funneling all the wealth on the planet into the pockets of as few shitheads as quickly as poss.
Efficiency is directly proportional to the amount of employees. Government has too few, while private companies have more. There are 60K people employed by Social Security to service 70M customers. That's one employee per 1100 customers.
I'm not certain that's a fair sampling. You picked an "industry" where the customers are required to buy, and the company treats them as the enemy.
However, I do recognize that "private companies" is way too broad a term, even when used by its proponents.
For me, the big problem is goals. For any public utility or service where the goal is ensuring that residents have access, it needs to be publicly owned and managed. Private industryβs goal is highest possible profit for owners or stockholders. Fine for private cars, not for city busses.
Ah, but you have to remember that the insurance company works for its shareholders, not the customer. As such the more claims they deny, the better they're doing their job. And they're dreadfully efficient at that. They've even started using AI, I'm told...
Governments have to be transparent about their inefficiencies. If Coca-Cola had to testify before Congress every week shareholders would probably be mortified by the "waste."
The efficiency logic generally falls down hardest when it comes to essential services. If something is crucial enough that it absolutely needs to be provided, then the only real goad to private companies to be efficient (providing good value for money) goes away since they can't be allowed to fail.
It always struck me as weird that one of the big arguments against any kind of socialized health care has long been "You want the government choosing your doctor for you?" when that's what my insurance company already does?
The fact that one is to take care of the countries needs and the other is ALL ABOUT PROFIT should be the most glaring red flag. Screwing over 50% or more of the population isn't "efficient" for anyone other than the greedy Billionaires.
An insurance company's job is literally to NOT provide insurance payouts, it's their responsibility to their shareholders, the whole system is bullshit
Private conpanies exist for profit, which means you've now got an organization trying to do the same work government was doing but now the whole system is losing money to that profit. How can that be better?
I'll never forget being on the phone for two hours leading up to a fertility doctor appointment and breaking down and desperately telling the BCBS agent, "I don't know. It's your job to know how that works between your departments. It's not my job. My job is teacher."
In general, I think large, top-down bureaucracies -- whether corporate or state -- are less efficient than small ones that are run by people in direct contact with the situation who experience the consequences of their decisions.
[Drunkenly wades in with] You can always choose to regulate a market. That depends of course on the strength of your democracy and the education levels of those participating in it.
I worked at the UKs largest insurance company and it was totally inefficient, tech releases quarterly. Brokers had to be given personal iPads to get them to stop using notebooks. Claims handled really slowly,
I mean how many rockets have exploded by these "private" space companies because it was "ready enough" and not NASA ready. (Not that NASA was perfect but when given time NASA lost far fewer missions).
They are more efficient at infirstructure in the US, given the government seems to prefer hiring private companies to build infirstructure for no god damn reason
You picked one of two industries that make interacting with them terribly frustrating on purpose. Anyone who things the government is more efficient has never had to work with the govt directly (say this as a SWE @ a defense contractor)
People who claim private companies are more efficient than the government are usually politicians who have zero (or very little) experience in the private sector
Efficient isn't always good, either.
Private companies love profit, period.
They'll kill to get it too, because a class action lawsuit is cheaper, no one goes to jail, and everyone except the victim's families get richer.
I've worked at an insurance company for 10 months as of today, and can say with 100% certainty that a highly process-driven, documentation-heavy government agency would 100% be better at this than what I see here. The chaos and flailing is like nothing I'vee seen in 21 years in healthcare IT.
I think private companies tend to be more greedy than the government. This makes them look good on paper (less waste, tighter margins). However, they almost never provide better service unless they directly make money from the customer service part of the business.
Iβve worked in private companies with 1 employee, up to tens of thousands. I also worked on a state IT project that was shut down due to massive cost overruns and mismanagement.
IME, that failed state project was about mid-tier in terms of efficiency.
Everyone knows a guy who knows a guy who knows a guy who had a bad experience with the government, but in my experience, the same people justify the same mistakes with private companies as well as the rampant price gouging and occasional βinhuman practices.β
I am always shocked at the people who wouldnβt dare place their healthcare in the hands of an inefficient government worker, but instead defend placing their healthcare in the hands of for-profit companies that generate more shareholder value the more healthcare they withhold. Mind boggling.
