It's easy to feel like a "jackass whisperer" when trying to give advice to Governor Pope and Deputy Assistant Governor McCrory. It's not that either man is dumb, but it's safe to say they both suffer from a version of the Midas Complex. Pope, in particular, reduces the entire world to dollars and cents, which is why his career as a slum retailer has been so successful.
When it comes to the broader social goals, however, neither man has the sense god gave an animal cracker. So in the spirit of taming jackasses everywhere, I offer this provocative article from the business section of today's New York Times.
Our reliance on private enterprise to provide the most essential services stems, in part, from a more narrow understanding of our collective responsibility to provide social goods. Private American health care has stood out for decades among industrial nations, where public universal coverage has long been considered a right of citizenship. But our faith in private solutions also draws on an ingrained belief that big government serves too many disparate objectives and must cater to too many conflicting interests to deliver services fairly and effectively.
Our trust appears undeserved, however. Our track record suggests that handing over responsibility for social goals to private enterprise is providing us with social goods of lower quality, distributed more inequitably and at a higher cost than if government delivered or paid for them directly.
But it's even worse than you think.
A quarter of a century ago, a belief swept across America that we could reduce the ballooning costs of the government’s health care entitlements just by handing over their management to the private sector. Private companies would have a strong incentive to identify and wipe out wasteful treatment. They could encourage healthy lifestyles among beneficiaries, lowering use of costly care. Competition for government contracts would keep the overall price down.
We now know this didn’t work as advertised. Competition wasn’t as robust as hoped. Health maintenance organizations didn’t keep costs in check, and they spent heavily on administration and screening to enroll only the healthiest, most profitable beneficiaries.
I have zero confidence that Governor Pope has enough of an open mind to consider that he and his multimillion dollar opinion manufacturing machine have been fundamentally wrong in their free market fanaticism, but perhaps DAG McCrory hasn't yet drunk a fatal dose of Mr. Pope's magic kool-aid.