You’ve probably heard that health care costs are “less” in (insert name of country) than in the US. That their “vital statistics” are “better” than ours. Supposedly proving that government run health care delivers better results at lower cost than does our own.
So, is any of this really true? Most people would compare the difference in cost and say that it is. And it does appear to be true at first glance. They do pay “less” and do “better”.
However, there are reasons why. Under a single payer health care systems doctors are effectively employees in that they have little choice but to accept what the system has agreed to pay. Additionally the the doctor in most of these countries has his or her own education paid for by the government. This means either much less money out of their pocket or student loans. Plus the government sets what the rate of pay will be for the educational system so that too is more like working for an employer. Organizations like our AMA are either not allowed or become more “company unions”. The idea of being a self employed health care provider as exists here in the USA doesn’t exist in the same form there. In effect while the pay is fairly good (middle class level), they don’t make in fact the same level (relative to everyone else) that doctors can earn today in the USA. It compares in some ways to what working for the VA was like before the Republicans got the idea of cutting payments which then resulted in veterans not getting the care they deserved. (there was also now apparently a certain level of “fraud” going on there too) The quality of service was generally good, but not as outstanding as could be found in some centers of medical excellence where the best medical providers preferred to work. The VA did make some “advances” that exceeded the general level of health care, but in ways that were more possible for a government agency (use of computers for one) where a level of standardization could be established over the entire system. Something in fact far more difficult when dealing with thousands of private independent establishments.
If you spend enough time studying these issues, you will also note that the US is where a lot of advanced medical innovations start. The same is true of medical drugs, although in some cases other countries will “OK” a new and still rather experimental drug before the US FDA does. Obviously we could do the same thing (and we should) giving people the choice of trying new drugs and/or treatments before they get a final clearance. The main reason we don’t has more to do with our legal system and resulting concepts of liability culture than anything else. However this could be easily changed by granting patients an enforceable legal right to use the treatment and drugs they felt best fit their situation… Something more likely to be supported by libertarians than by today’s Democrats or Republicans. Both of whom have drunk deep of the sweet seeming poison of statism.
We could easily reduce the cost of US health care by a large percentage simply by now removing the statist laws and regulations that make US health care so expensive. The elimination of prescription laws alone would reduce health care costs by hundreds of billions of dollars. The elimination of medical licensing (replaced by certification) also would reduce health care costs by comparable amounts. The “replacement” of health insurance by medical savings accounts that can be “invested” at good rates of interest effectively decrease costs by 20 to 25% compared to private health insurance. All told, we could drop US health care costs to levels as low if not even lower than what the other developed countries are paying for health care. It hardly makes sense to copy them when we can obtain equal savings by simple elimination of all the “waste” built into our health care system. We do need to also look at reforming patent and copyright to control the monopolistic aspects, but that is a part too of getting rid of “Too Big” government….
On another topic, I have argued that religious freedom is an “individual right”, but that no one has the right to force their religious views upon others. Unfortunately, at least two of the major religions don’t agree with this. At the current time the Supreme Court has decided on a 5 to 4 decision that employers don’t have to pay for insurance that covers certain reproductive issues if it happens to violate their religious beliefs. The problem here is that an insurance policy that does not cover these things is no longer “legal” under the rules of Obamacare. As a matter of fact, as a private individual, you cannot buy a private policy under Obamacare that does not meet the standards set up under the Obamacare law. So even if you object to the policy having coverage for those reproductive issues that are against your religious beliefs, you cannot use “freedom of religion” to refuse to purchase a health insurance policy under Obamacare except under certain circumstances where you do not rely upon medical means for health care or are a member of a “health sharing ministry” where the cost of health care coverage is shared by the group in question.* There is also an exemption for religious groups themselves.
*Here on WordPress there is a “blog” about paying cash instead of using health insurance with doctors willing to discount their services if paid in cash instead of having to bill an insurance company. Google for “selfpaypatient.com” for more information. Apparently you can qualify under Obamacare for “coverage” by joining one of the health care sharing ministries. Which would likely result in savings for those of higher income.
This creates a very “interesting” issue in that private individuals cannot use “religious freedom” to exempt themselves from the purchase of an insurance policy that meets the requirements set out under the law. So a man who buys a health insurance policy also has to pay for childbirth costs even if he will never have any children. Apparently this was done since otherwise women will have to pay higher premiums than men would!
I have suggested that a much better solution to all this would be to use “Health Savings Accounts” where the money that is not used for immediate care can be invested. It is not that difficult to obtain a return of at least 5% on the money invested*. Effectively the money in a health savings account has no actual “overhead”, and with a return of 5%, actually gains 25% over premiums paid to health insurance companies. This could also be “backed up” by a major med policy that has a very large deductible. These policies at the current time are far less expensive than a general full coverage type of insurance.
* Vanguard index funds invested 50/50 in stocks and bonds.