One of the benefits of having been in the federal workforce and addressing the economic side of projects, plus having to justify one’s own job during a study to see if one should be replaced by the private sector, is running across the actual efficiency rates of the federal government. This was broken out by Agency and it was shocking to discover that the workplace I was in was actually one of the most ‘efficient’ in the government. Here efficiency is the percentage of time each individual actually spends doing productive work out of a given day, with the rest taken out by administrative overhead or other things that eat up time while not being productive. That industry average was 80% (meaning out of an 8 hour day, an individual was expected to have 6.4 hours of productive work time). In my agency the percentage was 65% which was good compared to the rest of the government that averaged 55%, and some notable offices at 45%.
For the administrative overhead of tracking to make sure everyone is covered, the federal government will spend almost 3 individuals to get what 2 could do in the private sector (when compared on job equivalent work). Strangely enough when contractors come to a government worksite, their efficiency decreases to near the norm of the workplace they are in, thus rendering ‘savings’ of site work useless. When done out of that environment, or off-site, efficiency returns. This is why ‘savings’ of going contractor on-site only show that for the first year or two, and then costs ramp up to cover the time needed to complete increasing workloads as efficiency of contractor staff drops.
Now consider that on top of the ‘health care system’ which is famous for having high amounts of clerical paperwork to address billing, legitimacy of bills, and ensure that the company involved is not being defrauded (the federal government has similar problems on contract work, requiring contract officers and their representatives to do similar work, but at lower efficiency). John Stossel looked at this last year in Bad Medicine, which looks at these overhead costs and their increased overhead being added into the cost of health care.
Doctors, by that view, now spend 14% of their costs on just tracking insurance paperwork, and having numerous conditions I have noticed that doctors have hired ‘non productive staff’: non-medical individuals to track paperwork. Of the non-doctor staff, I have seen this go as high as 50% of the total staff being clerical staff to track paperwork. The money you pay into ‘health insurance’ covers all the paperwork systems and individuals in the insurance part of the system, with additional amount going to the pay of non-medical staff for physicians and their increased insurance overhead against malpractice suits… the actual amount paid to medical practitioners, then, if you remove these portions, lost doctor time in having to justify medications and diagnoses, plus the non-medical overhead from private companies and staff, yields a small percentage of one’s budget to health care actually going to doctors and medical staff.
What we now pay for is a paperwork tracking system (even when electronic) that, as a minor output, provides some medical care. In trying to cover the ‘uninsured’ that paperwork will escalate and so will the needs of all the players to track, verify, check payment, cross-check and then run checks against fraud. This will increase the cost of the entire system while providing little, if any ‘added benefit’ to all involved.
In that era before ‘health insurance’ covered so much, hospitals would offer longer term plans for poor individuals to pay off a large debt, and charitable institutions also ran hospitals for the poor and destitute. Today those institutions are failing because we give less to charity and more to insurance companies and business to over-charge us in the long run for care needed in the short run. There used to be a time when Americans took care of the poor via charity and utilized their own outlook to find efficient institutions to do good work for them. Government was never considered to be that place as its role as punisher is directly opposite to that of charity. By confusing society with government we, as Tom Paine points out, replace the source of good with punisher of evil. And that is not progress in anyone’s book.
