June 20, 2007, 10:39 pm

Apparently, HMO's only have a 15% approval rate with Americans. People don't like the waits, and the institutional service, but, more than anything, they don't like someone in the HMO back office rationing their care based on pre-set formulas about what care or test is appropriate in each given situation.

All well and good. However, if this is so, then why does the idea of universal government health care appeal to so many people? Because if universal health care turns out as well as it possibly could, then the best we could expect is that it will resemble... current HMO's. And unfortunately, it will probably be worse. Because today, the guy in the HMO back office who is setting up the allowed care formulas knows that if he cuts things back too far, you will go to another competitor. No such threat or incentive will exist for the government bureaucrat, who will be setting the formulas based on stupid mindless rules and interst-group pressures and absolutely no concern about your satisfaction.