The Incontiguous Brick

August 7, 2009

Why not model a Govenrnment Health Care plan after the FAA?

The FAA model brings up an interesting example in support of government run health care.


There is a definite problem with the current healthcare system. If you have private insurance and get become very sick, the insurance company has an strong motivation to find a way to cancel your policy. Although this makes sense for the companies bottom line, it is not exactly what I would call insurance. Most of us would like to imagine that “insurance” means: any means of guaranteeing against loss or harm. But this goes away when it is a for profit industry that does not want to pay for loss or harm. And quite frankly, if I was an invester in an insurance company, I wouldn’t want them to cut into their profit to pay for your illness either.


However, the idea of the government providing for our health care sends chills up the spines of most conservatives and many liberals. Do we really trust the government with our lives? I argue that you already do… every time you board an airplane in the United States you are trusting the FAA.


Here is one way to model the field of medicine after the FAA and it just might work:


Doctor Pay:

ATC controllers are highly paid and they make more money at larger airports (so rewarded for skill and hard work), have very demanding requirements, little room for error and are government employees. Maybe that is not such a bad model for doctors. Rather than pay them through hospitals that are billing insurance companies, why not have well compensated doctors (perhaps in a similar organizational structure as military doctors) that are paid a wage from the public coffers. Just like air traffic controllers who work at an airport but not for the airport (paid by FAA), doctors could work at hospitals but not for the hospital.

Medical School:

Obviously, we still want to attract the best and brightest to be doctors. Medical school is tough. It will stay tough. Right now it is expensive and tough and that means only people with wealthy families can become doctors (not always the brightest) or people willing to incur massive debt. This requires very high pay later to cover loans. Why not have medical education free and based solely on merit. If you are good enough to get in and finish the program, you are in the club. If not, see you later (and you owe for the ammount spent on you). No amount of money will get you in, rich boy. That makes it more like the Naval Academy which generally produces good officers.

Hospitals and clinics:

Offer free treatment to any citizen (taxpayer) and get reimbursed from the government for treatment. This is still competitive because people have a choice where they go to see the doctor. Provide a crappy facility and you get less patients at your door = less money. Patients that are not citizens can also be seen but will be billed at the same rate that the government would have paid. The non-citizen can utilize a private health insurance provider if they choose or can pay out of pocket.

Alternative Plan:
How about combining health insurance with life and disability, so the company has a financial incentive to keep you alive and healthy?



  1. I agree that strong reforms in health care are needed. Health care cost have gone completely out of control…they’re currently 17.6% of our Gross Domestic Product (GDP) compared to 7% in 1970. The cost of malpractice insurance, medical equipment and medicine have driven medical cost to unreasonable levels.

    The first issue that needs to be addressed is wrongful medical lawsuit reform. Malpractice insurance has sky-rocketed in the past two decades because everyone is looking to place blame. Medicine is a practice, not an exact science, yet people try to predict patient outcomes with certainty. If you have a relative or friend that is the hospital in critical condition, you should not be surprised if they don’t make it….it’s really that simple.

    The cost of medicine and medical equipment has jump appreciably over the past two decades. Yes, it takes money to do research and development to provide medical break throughs, but when you can drive north of the border and buy the very same medicine for less than half the price there’s a problem.

    We have too few doctors who work way too many hours. I have few friends that are doctors and given that they have to repay their medical school tuition that make that much and work ridiculous hours. Honestly, I don’t care how good a doctor is, I’m not sure I want you saving my life if you haven’t gotten any sleep in the past 24 hours. The US military provides a perfect model for all of the US follow. Would-be doctors have their tuition paid by the government and then return the military several years of servitude. They are paid a fare wage (especially since they don’t have to repay medical schools loans) and they work reasonable hours.

    I’m an advocate of capitalism, but government run medical health care providing care to all of it’s citizens is exactly what the US desparately needs. We need a free hospital that available to taxpayers and is paid for by taxpayer. If you’re not a taxpayer you can still use the hospital, but you will have to pay a fee….just like most places around the world. One drawback for some is that you won’t be able to sue the doctor or hospital if something goes wrong. For some free governmental hospitals may not provide the level care they seek, that’s fine they can use the private hospitals for added assurance.

    Comment by Boutros — August 7, 2009 @ 11:30 am | Reply

  2. Though there are some comparisons that can be made between atc and the medical field, as an air traffic controller for twenty two years, I will point out one of the biggest problems that faces our air traffic system that I worry would be carried over to the health insurance field. Because of the inefficiencies of the government bureaucracy, our technology lags some 7 to 10 years behind the private sector. For example, the computers that handle my radar scope, present weather data, flight plans, predictive conflict alerts, and so on, was obsolete before we ever even got to start using it. My laptop has more power than the system that handles my air traffic data and radar. Sadly, this is typical of government outside of the military, because of the way contracts for new systems are farmed out. By the time a committee decides what is needed, bids offered and accepted, a design submitted, tested, revised, and retested, then field testing, what was originally a leading edge technology is now way past obsolete.

    It carries beyond the technology. The 7110.65, the manual of air traffic control, nowadays consists of hundreds of pages of legal jibber jabber, much of which are procedures put in place to protect the gov’t from lawsuit when accidents occur instead of procedures to expedite traffic and safety. As an example of what that leads to, a few years back I worked a VFR aircraft in trouble, below radar and lost, heading for an area of known severe icing. Through a lot of creative use of technique over the course of an hour, I got the pilot back to an airport where he landed safely. I was put in for a flight save (essentially a national pat on the back) since my supervisor recognized that, had I not intervened, the pilot quite probably would have ended up in a field in eastern colorado. However, when QA (quality assurance) listened to the tapes, they found 3 instances (out of nearly a dozen and a half) where I failed to include the word “suggested” when telling the pilot what heading to fly to find the Goodland, Kansas airport. As a result, I was reprimanded, and was told later by a manager, “Sometimes you have to put the agency’s well being in front of the users”. Essentially, they were worried that, had the pilot crashed, my failure to “suggest” headings in a non radar environment would expose the FAA to a lawsuit. Gaaah!

    I worry that a government run health care system would suffer from the same fate. Having watched the bureaucracy function (barely) from an insiders view for 20plus years has left me very cynical that any improvements are possible.

    Comment by doriltales — August 8, 2009 @ 2:31 pm | Reply

  3. Both really good comments. Doritales… I see your point and I commend you on your save of the lost pilot, the QA guy is a tool.
    Bureaucracy can be dangerous and the government is full of it. But you are suggesting that our current medical establishment is not aleady working toward playing it safe and avoiding lawsuits and limited by what the bureaucrats will pay for. I think the current system is already broken.
    I think Boutros said it nicely, “I’m an advocate of capitalism, but government run medical health care providing care to all of it’s citizens is exactly what the US desparately needs. We need a free hospital that available to taxpayers and is paid for by taxpayer.”

    What we have today is not remotely a free market. It’s a government-controlled system that’s designed to maximize profits for physicians, pharmaceutical, and insurance companies, at the expense of patients. At least the FAA is not a for-profit organization that is working to make money from safe pilots while cutting loose the lost pilot to save money.

    Comment by iknowkeith — August 9, 2009 @ 12:53 am | Reply

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