Does anybody actually support ObamaCare?

[Cartervol]

Let's see here, Social Security is basically broke, Medicare is going broke, Postal Service is going bankrupt, and our public schools for the most part suck out loud(Case in point Obama got elected) That's one big fail. Yeah government run healthcare is a great idea:crazy:

 

[gsvol]

Which are the conditions I assumed when I showed you insurance markets can have market failure (by the way, you just described the tenets underpinning neoclassical econ, which makes me wonder how little econ background you have).


Free markets CAN lead to market failure, especially in quirky situations (like insurance markets) where there is incomplete information or adverse selection.


If I can explain it to you any other way, I'd be happy to try. My guess, however, is that you started from a conclusion you wanted to reach, and worked backwards to find justification for it. Additionally, you seem to have difficulty staying on-topic; instead of calling people communists, you would be more interesting if you would demonstrate a logical flaw in the market failure example I gave.

Enjoy your christmas dinner.

Who did I call a communist???

I didn't try to say there was a flaw in the market failure example you gave, I'm saying your example is beside the point.

Why should the public be forced to bail out failed businesses??

Will govenmental control of any particular business guarantee there will be no failures?

Do you understand the term, 'moneytizing the debt??'

Do you have any examples of governmental failures???

Instead of attacking my understanding or lack thereof and telling me what I should or should not do, you might think of sticking to the topic yourself.

Do you support Obamacare???

You make a terrific 'example A' in as reflected in my post to OE.

 

[gsvol]

BTW, It takes a real winner to take my example using perfectly competitive markets and call it a "socialist talking point".


Yet you're the one throwing around the "re-education" term? Incredibly ironic. And sad.

And again, please excuse any attempt on my part to introduce any levity to the discussion, it would intuitively obvious to the most casual observer that it is misplaced when it concerns you.

Your apples/oranges explanations are typical of all socialist talking points which seek to obfuscate and deceive.

Let me explain my post, I will try to type slowly, use small words and be succinct.

Your text book example of market failure has exactly nada to do with the real life failures we've recently witnessed.

No one doubts there can be business failures in competitive markets, that's why it's called 'risk taking.'

Now would you attempt to inform me just how your text book example relates to support for or objection to Obamacare??

 

[gsvol]

Let's see here, Social Security is basically broke, Medicare is going broke, Postal Service is going bankrupt, and our public schools for the most part suck out loud(Case in point Obama got elected) That's one big fail. Yeah government run healthcare is a great idea:crazy:

Obama is having such a hard time selling his health care plan that he's thinking about putting it on eBay.

ObamaCare side effects may include swollen deficits, shortness of doctors, difficulty getting treatment, elevated tax rates and premature death.

If ObamaCare makes sense to you, it's time to up your medication.

ObamaCare medications should be hidden under the seat during routine traffic stops.

Barack Obama announced that his ObamaCare team will be headed by Joe Biden. Obama admitted that his team has many problems to overcome, the biggest one being that Joe Biden is heading the team.

Q. What is the Obamaaaa.....Care plan to prevent obesity?
A. That by destroying the economy it will discourage eating.

Q: What is the ObamaCare plan to encourage physical fitness?
A: Higher gas taxes to encourage walking.

Q. Why did President Obama feel it was necessary for him to apologize to the world and to degrade the United States?
A. Jimmy Carter had laryngitis.

Q. Does ObamaCare cover preexisting conditions?
A. Yes, but only if they don't require any treatment.

If Obama promises to be good next year, maybe Santa will give him a clue for Christmas.

 

[TNvol86]

Most of the arguments for ObamaCare supporters on here seem to be along the lines of "something needs to be done, ObamaCare is something, therefore it must be done."

This bill ignores the very real problems in the health care industry (I work in HC and am fairly well versed in it), and will go on to create a host of new problems. The biggest problem in healthcare is the cost, not who pays for it or who controls it. How on earth does it make healthcare cheaper to raise taxes on all aspects of healthcare, and then ban cost savings measures like high-deductible insurance and HSAs? This bill is great if the goal is to simultaneously bankrupt the government, American business, and American citizens all at the same time. This awful policy of massive tax increases, spending increases, and insurance mandates would be bad enough during the best of economic times, but to do this when unemployment is soaring to over 10% and rapid inflation is absolutely idiotic.

I just cannot see any logical reason an informed and rational person could possibly support this, and as of yet I've seen nothing posted by ObamaCare supporters that I think makes a cogent argument as to how this will not do more harm than good.

 

[shootermcgavin7]

I doubt many people with a background in economics are going to argue that adverse selection is not inherently present in insurance markets. Where I take issue with your stance is the assumption that government regulations, most notably, those within the current Senate bill are going to counterbalance those concerns.

Let me begin by saying I appreciate your even-keeled response. However, I never made that "stance" you refer to. My example was politically agnostic. I was simple demonstrating market failure. Nothing more or less.

That being said, in its most simplistic form, the negatives from adverse selection merely reflects the inability of the market to properly price a particular good due to an inability to properly set rates that reflect risk.

Yes.

Unfortunately, outside of mandating insurance coverage (such as is the case in auto insurance), government intervention has rarely proven that it can do much to combat adverse selection.

So, in your opinion, is mandating insurance coverage a way to combat adverse selection? I have my doubts (and it appears you do too), but you seem to assume that it works in auto coverage.



Let me repeat that I appreciate such a well-thought out response. One of a very few in this thread (or in any political debate).

 

[shootermcgavin7]

I didn't try to say there was a flaw in the market failure example you gave, I'm saying your example is beside the point.

My example is exactly the point. It shows that 99.9999999999999999999% of the far right which shrieks that "markets solve alllllllllllllll" failed their advanced microecon class (or did not make it to the class at all), which shows that markets can fail under their own assumptions.

While you are on the topic of "beside the point", you are the one who brought up bail-outs and inflation. Quite bizarre. I mentioned earlier that you have a real problem staying on topic. At least you admit you cannot find a flaw in my example where I showed using your own assumptions, insurance markets fail.

Thanks. I hope your dinner was enjoyable.

 

[shootermcgavin7]

Your text book example of market failure has exactly nada to do with the real life failures we've recently witnessed.

What a sad, sad example this is of our current education system. You obviously missed the earlier post on adverse selection. Here; the banking system and insurance system share a common burden. However, in one industry, private risk taking was guaranteed by the government, starting with Phil Gramm's big-shot work in the late 1990s.

 

[shootermcgavin7]

How about mandated heathcare is unconstitutional.....

It may not be against the "letter" of the Constitution, I'd imagine it is certainly against the "spirit" of it.

I think mandatory insurance is a horrible idea.

 

[TNvol86]

I support the bill and am actually grateful to have this opportunity. First let my classify myself politically because it is so relevant. I am very Liberal in all things not related to gun rights and state rights.

The bill sets up exchanges, that regulate the insurance industry. If ever there was an industry that needs to be regulated it is the insurance industry. All the control you seem to feel we are giving to the government on health care, is not being given to the government. The existing insurance system will stay in tact, just be regulated (such a good thing).

All the arguments about the government controlling what doctor you can go to, what treatments will be paid for, and how the government will control peoples lives is wrong. Insurance companies do this now and have been for a long time, but since there is no public option the government will have absolutely no hand in this.

So many abuses by the insurance companies have ruined peoples lives, that is why the insurance companies need to be regulated. I have so much more to say, but this got long, so I will wait for a few more posters, respond to them, and finish what I like about the bill later.

Thank you for starting this thread, I hope to debate many of you and look forward to it.

Would you not say that this bill goes against federalism and states rights? I am a huge proponent of federalism, and that is a major part of why I am opposed to this bill (aside from everything else about it). I think each state should be allowed to decide what is best in healthcare, just as the 10th amendment of the Constitution calls for. It really would not bother me if some of the more leftist states like Vermont decide to take over health care in their state, and tax the productive citizens of their state into poverty. But I think the more "freedom loving" states like Tennessee that want quality, affordable healthcare should be allowed to decide to pursue that as well. Seems that way, everybody would be happy, rather than forcing this unwanted bill upon the entire country. The reason liberals will not allow the states or the people decide what is best for them is because they crave power, and they view the American people almost as animals, and believe they know what is best for us more than we do. They also know what happens when liberal policies are enacted on a state level (see Michigan). They want to make it so businesses and people have nowhere to flee to, rather than allow people to do the mass exodus from liberal rust belt states to the sun belt that has occurred in recent decades (which, by the way, has greatly helped the economy of Tennessee).

 

[paul1454]

Let me begin by saying I appreciate your even-keeled response. However, I never made that "stance" you refer to. My example was politically agnostic. I was simple demonstrating market failure. Nothing more or less.




So, in your opinion, is mandating insurance coverage a way to combat adverse selection? I have my doubts (and it appears you do too), but you seem to assume that it works in auto coverage.



Let me repeat that I appreciate such a well-thought out response. One of a very few in this thread (or in any political debate).

You are right. I had mistakenly thought you were advocating the current Senate bill in an earlier post (I think it was jackaro that I had confused you with). My mistake.

And yes, I have my reservations as to whether mandatory coverage has done much to combat adverse selection in auto insurance. I am beginning to think that with all the negatives of insurance (i.e., adverse selection, moral hazards, and the susceptibility to price increases where there is a disconnect between the party directly paying for a good and the consumer), insurance itself may be more of a culprit with respect to rising costs than anything else. Certainly the same policies supporting mandatory auto insurance - notably to ensure a driver's ability to pay for damages he causes while driving - are not nearly as applicable to the health insurance market. Insurance really leaves the market in a catch 22. On one hand, the market won't naturally fix it and on the other, it is debatable as to whether ANY form of regulation can make insurance markets run efficiently (certainly, what is being proposed will not). Unfortunately, costs have increased to a point where getting rid of insurance companies altogether is not really an option as the public has gotten so accustomed to someone else footing their health bills, the backlash from requiring them to start paying out of pocket would be unimaginable. I think one step would be to begin forms of deregulation which would allow insurers to offer less inclusive plans such as those that only cover emergency and other unplanned illnesses - rather than the all inclusive plans we have now.

 

[gsvol]

Most of the arguments for ObamaCare supporters on here seem to be along the lines of "something needs to be done, ObamaCare is something, therefore it must be done."

This bill ignores the very real problems in the health care industry (I work in HC and am fairly well versed in it), and will go on to create a host of new problems. The biggest problem in healthcare is the cost, not who pays for it or who controls it.

How on earth does it make healthcare cheaper to raise taxes on all aspects of healthcare, and then ban cost savings measures like high-deductible insurance and HSAs?

This bill is great if the goal is to simultaneously bankrupt the government, American business, and American citizens all at the same time.

This awful policy of massive tax increases, spending increases, and insurance mandates would be bad enough during the best of economic times, but to do this when unemployment is soaring to over 10% and rapid inflation is absolutely idiotic.

I just cannot see any logical reason an informed and rational person could possibly support this, and as of yet I've seen nothing posted by ObamaCare supporters that I think makes a cogent argument as to how this will not do more harm than good.

Best, most astute observation I've yet to read on th topic. :good!:

My example is exactly the point. It shows that 99.9999999999999999999% of the far right which shrieks that "markets solve alllllllllllllll" failed their advanced microecon class (or did not make it to the class at all), which shows that markets can fail under their own assumptions.

While you are on the topic of "beside the point", you are the one who brought up bail-outs and inflation. Quite bizarre. I mentioned earlier that you have a real problem staying on topic. At least you admit you cannot find a flaw in my example where I showed using your own assumptions, insurance markets fail.

Thanks. I hope your dinner was enjoyable.

You make quantum leaps to conclusions of fig newtonian purportions.

I pronounce you shovel ready comrade, as a matter of fact I'm going to nominate you to the central commitee to be elevated to the position of commissar of shovel dispensation.

What a sad, sad example this is of our current education system. You obviously missed the earlier post on adverse selection. Here; the banking system and insurance system share a common burden. However, in one industry, private risk taking was guaranteed by the government, starting with Phil Gramm's big-shot work in the late 1990s.

The banking and insurance systems share a common burden because of Clinton policy that let the wolf into the sheepfold.

After all the ponzi schemes and three card monty played on wall street, the American people were left holding the bag.

It may not be against the "letter" of the Constitution, I'd imagine it is certainly against the "spirit" of it.

I think mandatory insurance is a horrible idea.

So you oppose obamacare??

Mandatory health insurance and a 40% surcharge on those who can afford high end health insurance policies are in the bill.

The biggest problem is that no one really knows what all is in the bill.

 

[KB5252]

But who's going to be left for the rich people to take advantage of? :unsure:

No worries, the government will simply come up with a new poverty line. Anyone not driving a Benz will become the downtrodden poor man unable to afford the latest in 52" tv technology, the elite will simply turn their focus on taking advantage of them.

 

[shootermcgavin7]

And yes, I have my reservations as to whether mandatory coverage has done much to combat adverse selection in auto insurance.

However, requiring ALL drivers to carry it gets rid of the problem in my example........in other words, buying insurance doesn't signal you as a "bad type" to the insurer.

Most people will voluntarily purchase "actuarial fairly" priced insurance because of risk aversion. However, in the health insurance example, the insurance price is above this threshold.

 

[shootermcgavin7]

I pronounce you shovel ready comrade, as a matter of fact I'm going to nominate you to the central commitee to be elevated to the position of commissar of shovel dispensation.

Yet again, you cannot argue my main point in this thread, so you resort to crappy comedy and personal attacks. I would expect no less, given the state of both political parties in this country and their followers.

So you oppose obamacare??

I have made no reference to "obamacare" anywhere in this thread. My main contention is that people who think the market will automatically "fix" health insurance markets are incorrect. Many people take that as the baseline assumption, but even if you assume that markets are perfect this is not true.

You seem to have missed this, despite my being very clear several times about. Because this single point disagrees with your overly simplified worldview, you shriek and moan and hurl insults................instead of examining and/or attacking my argument logically. My guess is that you you don't like my conclusion but cannot find a problem with my argument........so I must somehow be wrong because the answer isn't what you like. Thanks for continuing this trend in your most recent post.

To answer your question: I think "forcing" people to purchase insurance is stupid, especially because it is not fairly priced (in the probability/actuarial sense). Every other type of insurance is voluntary, health insurance shouldn't be different.
Are you asking me what I think would be the best achievable outcome?

 

[KB5252]

Yet again, you cannot argue my main point in this thread, so you resort to crappy comedy and personal attacks. I would expect no less, given the state of both political parties in this country and their followers.




I have made no reference to "obamacare" anywhere in this thread. My main contention is that people who think the market will automatically "fix" health insurance markets are incorrect. Many people take that as the baseline assumption, but even if you assume that markets are perfect this is not true.

You seem to have missed this, despite my being very clear several times about. Because this single point disagrees with your overly simplified worldview, you shriek and moan and hurl insults................instead of examining and/or attacking my argument logically. My guess is that you you don't like my conclusion but cannot find a problem with my argument........so I must somehow be wrong because the answer isn't what you like. Thanks for continuing this trend in your most recent post.

To answer your question: I think "forcing" people to purchase insurance is stupid, especially because it is not fairly priced (in the probability/actuarial sense). Every other type of insurance is voluntary, health insurance shouldn't be different.
Are you asking me what I think would be the best achievable outcome?

I don't really think most republicans feel the market will correct things all by itself. I think we all understand there needs to be some fundamental changes in many facets of health care. Even dedicated conservatives would agree changes need to be made, the difference in opinion comes to a head when the issue of government control is brought up. Many simply do not trust the government because of their track record on the issue.

 

[J-P]

Obama is having such a hard time selling his health care plan that he's thinking about putting it on eBay.

ObamaCare side effects may include swollen deficits, shortness of doctors, difficulty getting treatment, elevated tax rates and premature death.

If ObamaCare makes sense to you, it's time to up your medication.

ObamaCare medications should be hidden under the seat during routine traffic stops.

Barack Obama announced that his ObamaCare team will be headed by Joe Biden. Obama admitted that his team has many problems to overcome, the biggest one being that Joe Biden is heading the team.

Q. What is the Obamaaaa.....Care plan to prevent obesity?
A. That by destroying the economy it will discourage eating.

Q: What is the ObamaCare plan to encourage physical fitness?
A: Higher gas taxes to encourage walking.

Q. Why did President Obama feel it was necessary for him to apologize to the world and to degrade the United States?
A. Jimmy Carter had laryngitis.

Q. Does ObamaCare cover preexisting conditions?
A. Yes, but only if they don't require any treatment.

If Obama promises to be good next year, maybe Santa will give him a clue for Christmas.

Funny stuff. Bravo!

By the way, I was watching Doctor Zhivago last night and I think that Obama's obesity prevention plan is the same one the Communist regime used in Russia in the early days of their takeover. :question:

 

[shootermcgavin7]

I don't really think most republicans feel the market will correct things all by itself. I think we all understand there needs to be some fundamental changes in many facets of health care. Even dedicated conservatives would agree changes need to be made, the difference in opinion comes to a head when the issue of government control is brought up. Many simply do not trust the government because of their track record on the issue.

I think government action, by definition, tends to be inefficient. The problem is that when markets fail, there are not a whole lot of other options.

 

[KB5252]

I think government action, by definition, tends to be inefficient. The problem is that when markets fail, there are not a whole lot of other options.

It could be argued that the government shares a part of the blame for the mess we see today as well. There are many drains on our current health care system, illegal aliens, those who are the second or third generation of welfare recipients etc. These parts of the overall problem where brought on by either the failure to act, or the unintended consequences of government action or intrusion.

Granted the two ideas above are but a portion of the overall problem, the fact still remains that government plays a role in the failure. Our government will not address some of the main issues because to do so would be stepping on a political land mine. I cannot trust the government to fix health care when it will not or cannot address the issues that contribute to the problem.

 

[shootermcgavin7]

It could be argued that the government shares a part of the blame for the mess we see today as well. There are many drains on our current health care system, illegal aliens, those who are the second or third generation of welfare recipients etc. These parts of the overall problem where brought on by either the failure to act, or the unintended consequences of government action or intrusion.

Granted the two ideas above are but a portion of the overall problem, the fact still remains that government plays a role in the failure. Our government will not address some of the main issues because to do so would be stepping on a political land mine. I cannot trust the government to fix health care when it will not or cannot address the issues that contribute to the problem.

I think we are talking about two different things. Illegal aliens and the chronic poor have nothing to do with the evolution of an "efficient" health insurance marketplace, which is what I'm mostly concerned with.

Specifically, your quote:

I cannot trust the government to fix health care when it will not or cannot address the issues that contribute to the problem.

I'm trying to say that the problem is inherent in the way insurance markets work.
No one caused it, that's the way the world works under adverse selection. It is like blaming Mexicans for the fact that beans make you fart.

 

[shootermcgavin7]

It could be argued that the government shares a part of the blame for the mess we see today as well. There are many drains on our current health care system, illegal aliens, those who are the second or third generation of welfare recipients etc. These parts of the overall problem where brought on by either the failure to act, or the unintended consequences of government action or intrusion.

Granted the two ideas above are but a portion of the overall problem, the fact still remains that government plays a role in the failure. Our government will not address some of the main issues because to do so would be stepping on a political land mine. I cannot trust the government to fix health care when it will not or cannot address the issues that contribute to the problem.

Let me rephrase. There is a problem that cannot be completely solved by markets. Who or what or what mechanism would you choose to solve the problem?

 

[KB5252]

Let me rephrase. There is a problem that cannot be completely solved by markets. Who or what or what mechanism would you choose to solve the problem?

The problem cannot be solved by any one entity, it's a multifaceted problem. There has to be a change on multiple levels, starting with the way we as consumers look at and use health care. The bottom line is there is simply no one entity that can come in and make this situation any better and that is my main problem with "Obamacare" it simply will not and cannot address and fix the issues we are having, in fact it will simply continue the trend we have set over the years of passing the buck down the line for the next generation to absorb. We simply cannot continue any further down this path.

 

[rjd970]

The problem cannot be solved by any one entity, it's a multifaceted problem. There has to be a change on multiple levels, starting with the way we as consumers look at and use health care. The bottom line is there is simply no one entity that can come in and make this situation any better and that is my main problem with "Obamacare" it simply will not and cannot address and fix the issues we are having, in fact it will simply continue the trend we have set over the years of passing the buck down the line for the next generation to absorb. We simply cannot continue any further down this path.

You hit the nail on the head with your first statement. No one philosophy is going to fix this. The pure free market approach and the pure government approach are both bad, IMHO. Some middling ground is the only other option, but that is kind of like what we have now and it isn't working. Some completely overhauled moderate approach to this problem is proabably the answer, but I don't begin to know what that solution looks like.

 

[paul1454]

However, requiring ALL drivers to carry it gets rid of the problem in my example........in other words, buying insurance doesn't signal you as a "bad type" to the insurer.

Most people will voluntarily purchase "actuarial fairly" priced insurance because of risk aversion. However, in the health insurance example, the insurance price is above this threshold.

Exactly. Mandatory insurance is the most widely recognized method of combating adverse selection. The problem is, adverse selection is only one of the many reasons for the rising costs of healthcare. Even if the inefficiencies in the health insurance market are addressed (which I still don't think are properly addressed in the current bill), healthcare isn't going to become automatically affordable to everyone.

A bigger problem that this bill does nothing to address, however, is the actual cost of health services. That is why I think this bill is nothing but baloney. I think a better approach to this solution would entail some or all of the following: (1) regulating minimum co-pays - i.e., say that co-pays cannot be less than X percent or X dollars [which would stimulate us to be more conscious of the prices we are paying in the healthcare industry, rather than allowing consumers to spend blindly and let the insurers fight over the costs]; (2) allow insurance plans to be less inclusive - meaning that insurance does not need to cover every routine visit to the doctor, fertility treatments, etc - make consumers pay for these out of pocket and it will encourage price and quality comparisons and, thus, price competition; and (3) tort reform - it is amazing how many costs are built into the system just because the doctors are so worried about covering their tails. [I had another idea but it seems to have escaped me at the moment].

I also think an alternative to the current plan would be to entice states to require insurance coverage by attaching stipulations to federal funding - rather than the tax penalties in place that are merely another example of the federal government stretching its constitutional powers beyond that which most would agree are present. If everyone, save those below the poverty line, had insurance and those below the poverty line had Medicaid, the federal government could repeal those laws requiring any person to be treated at an emergency room. Thus, these unfunded ER costs would no longer need to be shifted to the rest of the market. Unfortunately, this approach would never pass political muster as few congressmen or women would sign onto a bill that possibly would throw on the streets both illegal immigrants and those above the poverty line who chose not to purchase mandatory health insurance (I must be cold hearted, because I certainly would).

 

[shootermcgavin7]

Exactly. Mandatory insurance is the most widely recognized method of combating adverse selection. The problem is, adverse selection is only one of the many reasons for the rising costs of healthcare.

I agree. However, I don't have a philosophical problem because you can avoid paying auto insurance (if you don't drive). That may or may not practical, but there is still consumer choice involved. I DO have a philosophical problem for making people purchase health insurance simply for existing.

Even if the inefficiencies in the health insurance market are addressed (which I still don't think are properly addressed in the current bill), healthcare isn't going to become automatically affordable to everyone.

I agree.

A bigger problem that this bill does nothing to address, however, is the actual cost of health services.

I don't think the cost of health services SHOULD be regulated. Medical providers should operate in a competitive market. In my mind, the labor market for doctors and the consumer market for their services are no different than that for, say, an accountant.

That is why I think this bill is nothing but baloney. I think a better approach to this solution would entail some or all of the following: (1) regulating minimum co-pays - i.e., say that co-pays cannot be less than X percent or X dollars [which would stimulate us to be more conscious of the prices we are paying in the healthcare industry, rather than allowing consumers to spend blindly and let the insurers fight over the costs]; (2) allow insurance plans to be less inclusive - meaning that insurance does not need to cover every routine visit to the doctor, fertility treatments, etc - make consumers pay for these out of pocket and it will encourage price and quality comparisons and, thus, price competition; and (3) tort reform - it is amazing how many costs are built into the system just because the doctors are so worried about covering their tails. [I had another idea but it seems to have escaped me at the moment].

I also think an alternative to the current plan would be to entice states to require insurance coverage by attaching stipulations to federal funding - rather than the tax penalties in place that are merely another example of the federal government stretching its constitutional powers beyond that which most would agree are present. If everyone, save those below the poverty line, had insurance and those below the poverty line had Medicaid, the federal government could repeal those laws requiring any person to be treated at an emergency room. Thus, these unfunded ER costs would no longer need to be shifted to the rest of the market. Unfortunately, this approach would never pass political muster as few congressmen or women would sign onto a bill that possibly would throw on the streets both illegal immigrants and those above the poverty line who chose not to purchase mandatory health insurance (I must be cold hearted, because I certainly would).

I have a lot simpler solution. Or to say it another way, an experiment. Scrap the entire 8 trillion page healthcare plan. Have the government start a health insurance company, with rates set exactly to meet the required return on capital which will compete with private insurers (in other words, self-sustaining). If the government is as bumbling and inefficient as everyone thinks it is, it won't last very long. However, if economic theory is correct and selling actuarial fair insurance is optimal, then private insurers will be forced by competition to lower their administrative costs to levels seen in other western nations.