大使命52

官僚政府的沒有效率

在寫這篇文章時，美國正掙扎於抵擋社會主義或馬克斯主義的主要爭議─就是人們所知道的歐巴馬健保。倘若你來自另一個國家，請忍受我提到此，因為它確實照亮在資本主義和社會主義之間的終極議題。

在政府開始接管我們的醫療制度前，美國擁有全世界最好的醫療保健，它是我們主要的輸出品之一，人們從世界各地來到這裡就是為了醫療。此外，在美國的每一個人，包括非法居留者，都擁有免費的緊急救援醫療。急診室若拒絕給人緊急救援醫療是違法的，一些善心人士也提供許多非緊急醫療的免費門診來幫助窮人。雖然仍有瑕疵，正如沒有一件事是完美的，但這卻是沒有政府接管時最好的情況。此前所未有的越權已大大降低醫療制度的品質，減少醫療可以觸及的人數，花費卻戲劇化地提高，而政府甚至還沒有開始呢！

我們的總統承諾，我們若讓政府接管，很快每個人都會有健保，我們會省下更多錢。除了國防和安全外，我們看不到任何一個政府妥善管理的例子。當他們嘗試如此做，花費總是增加，品質卻下降。我們很快發現，政府甚至無法架設一個網站。我們的健保花費已經猛然上漲，一些保險項目的花費甚至是從前的十倍！

正如我們現在所發現的，令人質疑的是，是否那些沒有保險的人，也就是歐記健保想要幫助的對象，將會真正得到保險。另有三億的人最後反而要付更多的保費，更慘的是，整個醫療制度的品質很快就下降。無論原意有多好，結果卻成為每個人的夢魘，而夜晚才剛開始。

正如上週所提到的，我們需要政府像運動場上的裁判一樣；然而，當政府接管一個企業，就像裁判決定要下場比賽。想一想當我們觀看一場足球賽，裁判開始跑進來踢球，整場比賽一定大亂。因此，這就像我們政府接管美國最大企業─醫療保健。

沒有任何政府有能力承擔我們社會最複雜的部分─醫療保健，只用幾天的時間寫法案，而且多半由議會職員所完成，就能變成一個更好的制度。單是想這可能發生就難以置信，倘若你還沒有留意，在華盛頓所發生的事遠超過異常，簡直是瘋狂。

以最戲劇化和令人震驚的方式，歐記健保的輪子正在脫落，但這對瞭解基本管理的人而言卻不該感到意外。沒多久前才剛宣布，有許多人還沒登記交換政府的健保就已經喪失目前的醫療保險。此災害在歷史上很可能會被記載為政府有史以來最越權的一個，我們會從中學習嗎？倘若我們繼續跟隨歷史的循環，答案有可能是不會。

我們可能會納悶為何其他國家有全民健保，我們卻不能有？因為沒有其他國家試圖在二週內為他們的政府立法，以接管極度複雜的健保企業。沒有任何國家的領袖說先通過法案，然後你就可以看到內容。這種程度的傲慢與不適任，甚至連共產國家都不會如此表現。

當鐵幕垮下時，我們才得以真正見識到共產主義下的生活樣貌，其中最先發現的就是蘇聯的醫療制度落後西方國家四十年。當然，雖然每個人看病都不用錢，卻遠比不上他們所付的錢─完全比不上！你可能要排好幾年才輪到做一個檢驗。一個蘇聯工業的象徵─蘇聯市民可以得到迷你的二行程汽車，只不過你必須花一整年的薪水，等上16年才能擁有它。

官僚政府所做的任何事幾乎都做得很糟而且沒有效率，儘管在政府中還是有一些很棒的公僕，但其制度和成堆的繁文縟節與規定，使得再傑出的人都受其阻礙而沒有效率。我們的政府可以維修網站的問題，但單是這樣做就造成火車脫軌，想一想政府會如何執行全國的醫療健保制度。此災害會犧牲許多人的性命，而且對我們整個經濟體系是一項非常真實的威脅。它也可能甦醒美國來看見這些事，開始改革，再次釋放全世界最強大的經濟引擎─此引擎會運行在自由上。

 (摘自喬納 word for the week, Week 52, 2013)


Inefficiency of Government Bureaucracy,
The Great Comission, Week 52
Rick Joyner

At the time of this writing, America is struggling with what should be a primary argument against socialism or Marxism—what is popularly known as Obamacare. If you are from another country, please bear with me as we address this, because it does illuminate some of the ultimate issues between capitalism and socialism.

Before the government started taking over our healthcare system, America had the best healthcare in the world. It was one of our main exports as people came here from all over the world for medical treatment. Also, everyone in America, including illegal aliens, had free emergency healthcare. It was against the law for an emergency room to deny anyone emergency treatment. Good-hearted people provided many free clinics for non-emergencies to help the poor. There were problems, as there is with everything, but they could have been better fixed without a government takeover of the entire industry. 

This unprecedented overreach has already degraded the quality of the healthcare system, reduced the number of people it is available to, dramatically increased the costs, and the government has barely gotten started!

Our President promised that if we would let the government do it, everyone would soon have health insurance, and we would all save money. With the exception of defense and security, we do not have a single example of government managing anything well. When they try to do so, costs always go up and the quality of the product goes down. As we quickly discovered, the government could not even put a website together. Our healthcare costs have already skyrocketed, in some cases the same coverage costing ten times as much as before!

As we are now finding out, it is questionable whether the uninsured, those whom Obamacare was intended to help, will actually get coverage. The other three hundred million people are almost all going to end up paying much more for their coverage. Worse still, the entire healthcare system is being quickly degraded. Regardless of how good the intentions were, the results have been a nightmare for just about everyone, and the night has just begun.

As stated, we need government like we need officials to referee a sport. However, when government takes over an industry, it is like having the sports officials decide they are going to get involved in playing the game. Think about watching a soccer match in which the officials start jumping in and playing. It would be madness. So it is as our government takes over one of the biggest industries in America—healthcare.

No government exists that could take one of the most complex parts of our society—healthcare—and write a bill in just a few days, mostly done by congressional staffers, and come up with a better system. It was madness to even think this was possible. In case you have not noticed, what is happening in Washington is beyond dysfunctional, it is madness.

The wheels are coming off of Obamacare in a most dramatic and shocking way, yet it should not be a surprise to anyone who understands basic management. It was just announced that many times more people have already lost their present healthcare coverage than had been able to sign up for coverage on the government exchanges. This debacle will likely go down in history as one of the most extreme overreaches of government ever. Will we learn from it? If we follow the continuing cycle of history, the answer is probably not.

We may wonder why other countries have nationalized healthcare, so why couldn’t we do it? For one thing, no other country tried writing the law for their government to take over the extremely complex healthcare industry in less than two weeks. No other country had leaders saying to pass the bill first and then you can see what’s in it. This was a level of arrogance and incompetence that even communist countries would not have displayed. 

When the Iron Curtain came down and we were able to really see what life under communism was like, one of the first discoveries was that the Soviet healthcare system was about four decades behind the West. Sure, it was free for everyone, but it was hardly worth what they paid—nothing! It could take years for your turn to come up for just an exam. It was the symbol of Soviet industry—those little two cycle cars that were available to Soviet citizens, only you had to wait sixteen years for one and pay over a year’s salary for it.

Almost anything a government bureaucracy does will be done very poorly and inefficiently. There are some great public servants in government, but the system and its mountains of red tape and regulations can hinder even the best from being efficient or effective. Our government may get the website fixed, but if it created such a train wreck just doing that, think about what it will do to our entire healthcare system. 

This debacle is going to cost many lives and is a very real threat to our entire economic system. It could also wake up America to what is being done to it and begin the kind of reform that could again release the most powerful economic engine the world has ever known—the engine that runs on freedom.