I didn’t really see the value in this question. I did ask you to clarify what metric should be used to determine the “best”. That aside, I don’t see the point of it.
This is where we disagree and where math gets hard. Is the 100% difference a function of US citizens getting ripped off? How do you know? I raised these questions before and will raise them again.
- How much of the cost differential is attributed to higher wages in the US vs Europe? Countries with higher GDP’s tend to pay more in wages. We have a substantially higher GDP in the US vs European countries
- How much more care and medical costs do US citizens consume because of lifestyle issues or higher rates of obesity and other harmful factors.
- Are we less active than Europeans and therefore pay for that in the long run in terms of medical care.
- Do elective surgeries and procedures get counted into this cost differential? We have twice as many elective surgeries as the next closest country.
- Geographically, we are a much larger and disperse population. How does this impact the cost of servicing patients vs a country that has a footprint smaller than the state of Texas?
Does it make sense to you that these structural factors may play a large role in the cost difference that wouldn’t be solved by shifting to something that mirrors Europe’s approach?
I agree with you. We don’t take advantage of competitive forces in free market economies that would drive down costs. We also don’t fully take advantage of single payer systems that spread the costs over a broader insurable population. I share your goal of making it affordable without fully understanding which approach makes most sense, but I recognize the problem.
It sounds like what you are saying is the solution needs to be driven largely by eradicating profits or capping them and also the cost to deliver medical goods and services. I can tell you one thing scares the crap out of me. You start capping Doctor’s salaries in this country, you’ll find a lot of smart people aren’t going to want to spend 8 years in medical school, when they can devote less time to education and see a much better ROI. Further, I have little interest in turning over to Washington DC right now, 18% of GDP. For those that recall, the Clintons wanted to push through universal healthcare. When it didn’t work, Tennessee adopted a version of it as a more localized experiment. It was an utter disaster and ended up eating up nearly 1/2 the state budget.
But, I recognize there is a problem and it may take a number of different ideas to solve the problem. What may be the solution is where we segregate out the most vulnerable part of the population to provide an adequate safety net for the poorest and the oldest. The rest of the public may need to demand more price transparency while acknowledging that our own health is something we need to take ownership and finding some way to more efficiently and effectively insure this larger group.
One of our responsibilities is to make sure the next generations have the same if not better opportunities. What I am seeing is a set of failed social contracts looking for bailouts that will disproportionately impact those future generations. I have no interest in saddling them with more debt while we continue to ratchet back commitments or fail to deliver on public education, social security and medicare.
Further, I look around and see entire states and cities run by one party top to bottom that are absolutely failing to deliver on even basic social concerns. If anything, they have made the problems worse, increasing the cost of everything from education , food to housing and putting the American Dream further and further out of reach.
I see another party ignoring the problems and unwilling to show any fiscal courage to come up with an alternative plan or even prioritize what is most important.
Turning over the administration of healthcare to govt with this kind of track record, it seems as foolish as giving $1mil to an advisor promising to do better that squandered away $100k the first time around.