Friday, August 07, 2009

The DMV/health care metaphor

Quite a few right-wing pundits, tasked with the public denunciation of health care reform and the upholding of libertarian theology, have brought up the Department of Motor Vehicles. "Do you want hospitals to be run like the DMV?" they ask. (Or shout. Or shoutask or askshout.)

My responses:

1. Nobody is talking about changing the way hospitals and doctor's offices are run. This is about changing insurance.

2. The last time I visited a medical clinic (with a friend who ended up needing a difficult operation), much of the experience resembled waiting at the DMV. Same crummy plastic chairs. The DMV was better organized -- I was given a number and waited for it to be called by a RoboGirl with a pleasant voice. At the hospital, a nurse with an unpleasant voice yelled out names on her list. Since she did not have amplification, some patients missed their turn.

On the other hand, the DMV does not have a cafeteria, while that particular hospital has really good grub -- believe it or not. California could make a few bucks by selling food and magazines in DMV offices.

3. Last time I went in to deal with auto registration, the DMV wasn't as bad as all that. True, the morning mob looked dishearteningly massive when I opened the door, but traffic moved at a good clip. In less than an hour, I was done. Only Disneyland does crowd control more professionally. Sure, you and I could come up with dozens of ways to improve DMV service, but they would all cost money.

4. So let's say we privatized the DMV. And let's say that this private company did a better job of processing registrations. How much extra would you be paying? I figure at least a hundred bucks per vehicle. Would that trade-off be worth it to you?

6. Health insurers make money when they deny claims. Suppose a privatized version of the DMV had a financial incentive to deny you a license or registration. Would you end up driving or walking?

7. Ask someone who has had a major illness to describe his or her encounters with the insurance company. Now ask that person to compare the experience of dealing with the DMV to the experience of dealing with an insurer or an HMO. Which experience is merely annoying and which is downright appalling?

"The gummint is going to run health care the same way they run the DMV!" Oooh, scare me.

10 comments:

syborg said...

The irony of the guvmint worker versus the free market worker is that all these shouters have complete confidence in cops. And firefighters. And the army/navy/marines/etc. As you so correctly pointed out, I'll take the DMV over Comcast any day. Or PacBell.
With the DMV, I can renew my license or registration online in a couple of minutes.
Just one more frikkin' Reagan legacy; the myth of the lazy, incompetent federal worker.

run_dmc said...

Frankly - I've never had a hard time at the DMV, so I also never quite got the reference. Apparently, there are all these conservative pundits who are attacked by slacker government workers at the DMV every time they go there. Someone needs to tell them, that - after the first time and unless they move to another state - they can renew their tags an license over the intertoobz.

The last time I had to go to the DMV, it was completely smooth and painless - took about 15 minutes (on a Saturday, no less). Same holds true for the post office - very cordial, smart employees who were able to handle me sending an ipod to a relative in Malawi - no small feat as fed-ex couldn't do it - and took me (again) about 15 minutes.

Who knows, maybe I'm just blessed, but if that were true, why can't I ever win the damn lottery.

Anonymous said...

The other metaphor right-wingers use (and which you cited below) is that of the Post Office.

So lets look at that.



The health care system handles 80 million people per year and -according to statistics compiled from The New England Journal of Medicine, the Journal of the American Medical Association, and other promiment medical journals - at least 100,000 people die just from "hospital errors." That's 1 in 800.

In comparison, last I read, the USPS handles more than 80 million of pieces of mail per hour and loses about 1 in 237,000.


Hmm.


Sergei Rostov

Anonymous said...

I have ChampVa health insurance and have never been denied anything my doctors have ordered. As far as the DMV, the ones in my area are quick, professional, courteous, and downright friendly. So I'm not sure what comparisons anyone can draw from that, but I can't think of a single negative thing.

Anonymous said...

I teach in Michigan and we have an insurance company called MESSA. It is WONDERFUL. It covers most everything and errs on the side of the patient in terms of coverage and payment. I have never, never had a problem of any kind over the last 15 years.

It is for teachers only, but if this is similar to the co-ops they are talking about...we could do much worse.

Of course our insurance is always under attack by right wing think tanks, politicians and school board members. Fortunately we have a strong union.

liberalcommontater

Unknown said...

Joe, Have you seen this about SP's face book page?

Palin: Obama's "Death Panel" Could Kill My Down Syndrome Baby
http://tpmdc.talkingpointsmemo.com/2009/08/palin-obamas-death-panel-could-kill-my-down-syndrome-baby.php

What do you think of this?

Bob Harrison said...

NC has a public DMV but private contractors do the sales work at the local level. The tag offices, private contractors, vary widely in speed, efficiency, and service. The public DMV is somewhat slow but always courteous.

MrMike said...

Uhh ... shouldn't someone tell these right wing loony tune Senators and Representatives that they are government workers.
But then when they rail against inefficient perhaps it's personal experience speaking.
Note that none of them have yet to give up their government health care and buy private insurance.

Anonymous said...

There was a time, about ten years ago, that the DMV in my state had a bad reputation. At the point of a revelation of a scandal (corruption, I believe), the state did a complete overhaul of the system.

My experience of the DMV in the last ten years reflects what other posters are saying.

The right wing blowhards may be scaring the corporate media, but I doubt they're convincing the man/woman in the street.

DancingOpossum said...

Despite some long wait times, overall our DMV is pleasant, professionally run, and staffed by courteous and even friendly people. And in all my years of using the postal service I've been amazed by its efficiency and low cost, again with the caveat of occasional wait times. I WISH I could say the same of my crappy overpriced cable provider, my crappy overpriced phone company, or my truly crappy local hospital, known affectionately to us locals as "The North County Butcher Shop."