Proper role of government: fair broker

Government is an overhead expense, a drag on production, so of course we'd all like to minimize it.

Just as in a business, inventory is always a cost, it would be best to eliminate it completely; however, without an inventory there wouldn't be a business (not counting the goal of "just in time" production). Like inventory, we'd like to minimize government -- but like all overhead, it's there for a reason. Others before us have tried to get rid of it, from Ike to Reagan (tripled the national budget) to Bush (ran the debt over $12 Trillion). So what is the true role of government?

Let's look at ideals, some cases where the government succeeded without question. For example, seat belts. Left to their own devices, auto makers would have continued to offer seat belts as an option-only; some improvident people who think they will never have a crash would scrimp on seat belts. With less economies of scale, the cost would be higher. Why should we care? Those without seat belts would be injured more, and denied the protection they would have if they had made the "right" choice.

In steps the "fair broker", the government. By requiring that ALL recalcitrant auto makers offer seat belts as standard, it lowered the price, made it fair and lowered accident rates for all, ending the argument. Enabling air bags, because you can't have air bags without seat belts.

Take another: Social Security vs. individual investment. Given the bell curve, some people would do better than SS (forgetting for a moment that SS is also an insurance program); good on them. Some would do the same. But some, lamentably, just as surely as you lose at Vegas, would do much worse. They would buy Citi at $50, would have gotten caught in Madoff's madness, or bought bad mutual funds. To eliminate this, in steps the "fair broker" requiring at least the minimum retirement be quaranteed. Maybe you can do better, but at least you'll have this, is the idea. No dog food for improvident seniors, at least not those covered by SS.

And again, discrimination. Suppose everyone were free to exclude minorities or others (women, catholics, etc.); most businesses would remain open to all, but we'd see a proliferation of "WHITES ONLY", "NO MEXICANS" and "NO JEWS ALLOWED" signs, with even more aggressive "ARYANS ONLY" or "NAZI TATTOOS REQUIRED". This would certainly wet Rand Paul's undies, but would be in violation of the equal protection clause of the 14th Amendment -- plus violating our sense of fairness.

Perhaps government should not be involved in health care -- but why not? Analogously to seat belts, the current system doesn't work. You can close your eyes and ignore the current ignoble system and its outrageous injustice. But just one incident tells the story of failre. A 22-hour stay in UCI Medical Center led them to reams of paper bills for over $60,000.

A prudent, careful person would have had to pay that inflated bill, which was expanded by what is euphemistically called "cost shifting" from those who can pay to those who can't. If you have insurance, this outrage gets bargained down to the other rate, perhaps $5,000.

Yes, hospitals, insurers, medical companies and doctors use TWO SETS OF BOOKS, one for the in-crowd and the other for unlucky prudent citizens who always pay their bills themselves and don't have insurance. Drug companies, too, have two rates: one for blue cross, and a higher rate for small pharmacies.

The question is not getting rid of government, it's using it as a tool to make the sort of place we want to live in.

As "fair broker", removing the injustice and waste in the current health care mess, government has an important role to play. Only the government can force medical providers to stop their illegal "two sets of books" and wasteful cost-shifting from indigent care in the emergency room to those who have insurance or who pay cash.

Duly efficient health care rendered in a non-emergency, prophylactic role is always going to be cheaper, more humane, and more efficient than last-minute triage due to lack of proper care.