The present health care system started as a wartime expedient that had employers assume responsibility for providing health care to their employees. It was largely supported by the large industrial labor unions, as nationwide health insurance for all was beyond the Federal Government's ability to organize efficiently. That was in 194…
The present health care system started as a wartime expedient that had employers assume responsibility for providing health care to their employees. It was largely supported by the large industrial labor unions, as nationwide health insurance for all was beyond the Federal Government's ability to organize efficiently. That was in 1943. The problem was the transitory nature of employment relationships. We have a medicare-like system within the federal government, workers compensation for federal government employees, which is managed by the United States Department of Labor. They left a lot to be desired in the way of fairness and efficiency. One size fits all does not work well, because these organizations lose functionality with scale. The larger they are, less efficient and fair they become.
thanks for reminding us of the history, Arthur. I wonder how many people realize that 1) our current situation is, basically, an unhappy accident and 2) in an era in which unions have become increasingly toothless, that system has become just as increasingly unfeasible. now, a question that you seem extremely qualified to answer: do you think that your (obviously true) statement about organizations losing "functionality with scale" is an axiom relating to ALL systems at ALL times or do you think there are ways in which it's remediable?
well, let's hope we get to continue this dialogue. but I did sorta know that if the answer's yes, it's hardly an easy yes. I know we've both had to negotiate systems with varying degrees of success because I don't actually know anyone who hasn't....
The present health care system started as a wartime expedient that had employers assume responsibility for providing health care to their employees. It was largely supported by the large industrial labor unions, as nationwide health insurance for all was beyond the Federal Government's ability to organize efficiently. That was in 1943. The problem was the transitory nature of employment relationships. We have a medicare-like system within the federal government, workers compensation for federal government employees, which is managed by the United States Department of Labor. They left a lot to be desired in the way of fairness and efficiency. One size fits all does not work well, because these organizations lose functionality with scale. The larger they are, less efficient and fair they become.
thanks for reminding us of the history, Arthur. I wonder how many people realize that 1) our current situation is, basically, an unhappy accident and 2) in an era in which unions have become increasingly toothless, that system has become just as increasingly unfeasible. now, a question that you seem extremely qualified to answer: do you think that your (obviously true) statement about organizations losing "functionality with scale" is an axiom relating to ALL systems at ALL times or do you think there are ways in which it's remediable?
Not readily.
well, let's hope we get to continue this dialogue. but I did sorta know that if the answer's yes, it's hardly an easy yes. I know we've both had to negotiate systems with varying degrees of success because I don't actually know anyone who hasn't....