FE11: 1184AZ-Peebs Affordable Healthcare Act (Vetoed)

[Lumine]

Not a Representative, but I feel I must ask, why are private companies barred with competing with Health Fremont? Seems this would end private hospitals and private clinics (perhaps it's just me reading the bill the wrong way), and in the general sense, this does appear to be rather restrictive on the private sector (particularly since Health Fremont is basically being granted powers for price controls).

[Lumine]

I don't really wish to be disrespectful to the Legislature by intervening too much as a mere citizen, so I'll move my concerns into a different thread after this final intervention. Bit a long post, so I've divided it and tried to make it less tiresome to read (sorry, this issue drew my attention):

The Problem: True, we all want healthcare to work better for our citizens, but a particularly belief in a determined answer to healthcare (in this case, that the government and virtually only the government is the answer) should not be a reason to handwave what are not only matters of principle, but serious, practical questions of implementation of something that affects the citizens of the entire region. It's not about calling the effort "socialist" (I don't think I've done that), or dismissing it out of hand because of a personal belief that government shouldn't involved to that rather extensive and highly regulatory role, it's because the bill itself raises some relevant questions as it stands, and could perfectly do harm despite good intentions.

General Concerns: The problem, Mr. Speaker, is that the Commonwealth of Fremont is being forced into the use of this new Health Fremont organization in a way that is excessively regulated, and rather less than kind towards some fundamental freedoms both for the individual and for the free market itself. Instead of focusing on the improvement of the quality of current hospitals, or even doing our best to provide affordable to those who are in need of it, we're given an organization with incredibly sweeping powers, immediately put in a situation in which there is simply no possible competition because Health Fremont is now in charge of all the hospitals, all the medical centers, even the emergency clinics are not spared. Even more, Health Fremont is then able to set the prices at a whim.

Competition and Price Controls: So we go ahead, and Health Fremont grows out of nowhere (as this bill has no timetable, Health Fremont takes over an entire area of services out of the blue), eliminates most of its direct competitions in services, and then establishes price control, which when implemented in health care in places such as Japan or the Netherlands appeared to have made the situation worse, removing the potential for profit, driving down innovation and the desire to continue providing these services under such an unfair playing field, and ensuring a drain towards other regions with a more welcoming environment for healthcare innovation, unless we're taking of government handling the innovation process in a way that requires more research and government agencies, more fiscal spending and a situation that appears rather more inefficient.

Spending and Taxation: Then we reach the issue of spending, in a context in which we would open a budget hole of $300 billion at a time in which the region has not had a stable government until recently. But fine, we make that spending committment, and going by the bill we keep it close through a 5% sales tax whose only exclusion is groceries while taxing all other goods. I can see why some would think it a good idea considering the services it would pay, personally, I find it rather irresponsible to place that burden on small busineness and most of the region as a whole at a time which is already uncertain in economic terms due to a lack of political stability, which again, does not make for the best environment for future economic growth.

Semi-Conclusion: The general problem, then, appears to come in two different aspects: One, that this takes a basic principle of believing that healthcare is an essential service (which is perfectly valid and a sentiment most of Atlasia probably shares) but combines it with the belief that certain areas of private healthcare to "gouge" patients, which I find a bit of an offensive context for the work of private professsionals in health services, and thus goes too far in terms of empowering this organization for the sake of this version of the goal. And Two, that even separating this rather negative view of the private sector (which I must say, surprises me) and taking the noble goal the Speaker defends with sincerity, we're with a bill which is not accounting for many of the realities of implementation and consequences.

[Lumine]

In conclusion, the bill as written could present us with:

• The immediate implementation of an immense government organization without a timetable, with the subsequent bureaucratic nightmare, lack of efficiency, potential waste of resources, and so on.
• The destruction of an important part of healthcare services in the private sector, which could either mean closing all of these private hospitals, clinics and centers (thus raising unemployment) or moving into "nationalization".
• This potential nationalization or "regionalization" (does the word exist in english?) will either have a large, additional cost (by buying these institutions) or will be done in way which will probably worry many in the private sector and reduce trust in the Commonwealth of Fremont as a good place to invest.
• The implementation of price controls for the additional remaining private services in healthcare, with a negative impact in innovation and the profit of most of these companies, which can lead to the before mentioned loss of confidence, or the departure of these companies or individuals into other areas less hostile to their benefits.
• By the points before, the reduction of a large part of the services provided by the private sector, which even with the presence of Health Fremont will mean a loss in coverage and the situations we can cover, even when these private clinics or hospitals can save lifes.
• Furthermore, we're removing the fundamental freedom of any Fremont citizen to seek private healthcare if he so desires, and forcing him into using Fremont Health no matter the quality or context, or even if Fremont Health is not coping with the demand.

Sorry for the excess in words, but as you can tell I have some serious concerns about this bill and Health Care is precisely an issue in which we shouldn't rush into action without a good plan. I share the words of the Governor that this is indeed an excellent opportunity for a serious, detailed debate on the matter, and hope the Assembly does this with the responsibility they've shown in their past debates. But I would have to strongly assert that the bill as currently written would probably not be in the best interests of Fremont.

[Lumine]

This bill clearly wasn't nowhere near ready to be made into law, and I find it very distressing and disappointing that it was passed so casually.