I am in York, England watching the morning news. They are doing a story about their National Health Service’s attempt to computerize all sixty-two million patient records. The project began in 2002 with an estimated cost of £2.2 billion pounds. After nine years and spending over £12 billion ($18.8 billion) the system does not work and is about to be scraped. The reporters are asking where all the money went and why the project was not a success.
In 1993 President Clinton stood before Congress and held up a mock universal health insurance card illustrating the goal of each American having such a card with health records embedded so that this vital information would be available to all the patient’s health care providers. That dream is still unfilled eighteen years later.
We can’t seem to get it right or affordable in the public sector and yet within thirty seconds of a transaction I can receive this type of message from my bank.
This is an Alert to help you manage your credit card account ending in XXXX.
As you requested, we are notifying you of an international charge. This charge of ($USD) 47.23 was authorized at SIOPAU PORTMEIRION on 09/20/2011 8:42:16 AM EDT.
Wherever you come down on the health care debate, this simple example should tell you something about the ability of a large, politically controlled bureaucracy to get much done efficiently. The political promises and hype we see today are indeed tempting because they promise what we all want, but the reality is much different. Politicians are never aware of the law of unintended consequences. In addition, it is impossible for any long-term strategy to actually be followed. As in the example of banking, there is strong motivation in the private sector to be efficient and to meet customer expectations. That all may result in big bonuses for some executives, but so what? Efficiency and convenience is realized and competitiveness enhanced, can you ever say that about government?
The big government crowd may have genuine even noble goals, but they cannot be reached [look at the track record] and sustained through wealth transfer and government bureaucracy. bureaucracy is contrary to motivation and innovation.
PS: If you talk to Britons they overwhelmingly like their National Health Service. What’s not to like, there is virtually no out-of-pocket cost at the point of service. The entire cost is hidden in income taxes (20 to 50%), in the Value Added Tax (VAT) 20% on what they buy and on payroll taxes. On the other hand, the NHS budget is in trouble and they are trying to trim £20 billion according to the news reports.
In my view the perception that something is “free” because there is no direct and visible cost is the greatest danger created by government entitlement programs. There is, in fact, a tremendous cost which governments around the world are now realizing. When no one cares about the cost, everyone eventually pays dearly.
QUINNSCOMMENTARY 