This is interesting:
What government spends the most on health care?
- Is it Canada or the United Kingdom, which are famous (or, if these stories are any indication, infamous would be a better description) for single-payer healthcare systems?
- Is it Sweden, the home of the cradle-to-grave welfare state?
- Or France, the land of the world’s most statist people?
- How about Italy or Greece, nations that have spent themselves into fiscal crisis?
Nope, nope, nope, and nope.
The United States spends more money, on a per-capita basis, than any of those countries. Here’s a chart from a Forbes analysis prepared by Doug Holtz-Eakin and Avik Roy.
There are three big reasons why there’s more government-financed healthcare spending in the United States.
1. Richer nations tend to spend more, regardless of how they structure their healthcare systems.
2. As you can see at the 1:18 mark of this video, the United States is halfway down the road to a single-payer system thanks to programs such as Medicare and Medicaid.
3. America’s pervasive government-created third-party payer system leads to high prices and costly inefficiency.
Basically, healthcare in the US costs a lot because America is a prosperous, well-developed country where people have a lot of money to spend on medicine, combined with market distortions which have occurred because of government regulations and interference.
In this regard, we have read somewhere, but lost the link, that when adjusted for inflation healthcare was exponentially cheaper in the US prior to the introduction of Medicare and Medicaid in the early 1960s. Try as we might, we can think of no horror stories from before 1963 of poor people or the aged being turned away from hospitals because they could not pay for treatment. While it may have occurred, it was comparatively rare. This has become a common occurrence, on the other hand, since 1963. Indeed, until new laws were instituted in the late 1980s, there were multiple cases of people being turned away from emergency rooms, even if it meant they would die. Now, laws generally require hospitals to at least see and stabilize patients in emergency rooms. Since these laws do not require hospitals to schedule appointments for the indigent or the uninsured, in many cases the only way a person can see the doctor is to go to the emergency room, which is why emergency rooms in the US are filled to capacity 24/7. And of course, emergency care is the most expensive care there is. Medicare and Medicaid were thus the wrong solutions to the right problems.
Will the Affordable Care Act (Obamacare) make things better or worse? It has already made things worse. Because of new government regulations, people are losing their personal insurance and are being shifted to Medicaid. However, doctors and hospitals are not required to accept Medicaid patients, and many (most?) refuse to do so because the amounts they are reimbursed fall well below market prices and because of the bureaucracy and regulations involved. A government solution would be to require doctors and hospitals to take Medicaid patients. However, this would drive many doctors and hospitals out of business, and degrade the quality of care received. (Need an MRI, or expensive cancer treatment? Forget it.)
The solution for the doctor shortage would be to put all doctors on government salaries, as has been done in the UK. However, even a good government salary would not be high enough to allow the doctors to pay back their now federalized student loans, and putting the doctors on salary would do nothing to alleviate the problem of a lack of hospital beds, medical equipment, and new treatment options. In the UK, these have become pressing issues, resulting in long waits to get basic and necessary medical care, and a medical system in which the best new treatment option which is seen as affordable by the healthcare mandarins is euthanasia, but always under a new euphemism so as to keep the natives from becoming restless, lest they discover that the purpose of the hospital has now become to kill rather than heal.
Of course, there are always new regulations that can be proposed to “solve” these problems, and once one starts down this road, the only solution one is apt to see is the government. Fifty years ago, there were many charity hospitals (most religious in nature) to care for the indigent, and private hospitals would and could see people without insurance or who could not pay, being willing to offer a discount or even provide free care. Charity hospitals and private hospitals willing to provide free care still exist, but are becoming less common. Indeed, could it be that the US government sees charity hospitals as a competitor to Obamacare? That would explain a lot about its current behavior. Further, one obvious solution to the problem of people who would rather pay a government fine than buy increasingly more expensive insurance would be to forbid doctors and hospitals to treat anyone who is not insured or on government assistance. Since the logic of Obamacare is Obama’s way or the highway, this seems inevitable.
Such is the brave new world we have entered into. The basic problem is that people are searching for utopia, thinking that the government can solve every ill if it just put its mind to it. However, sometimes the best solution is to be reconciled to the fact that we live in an imperfect, imperfectable world, and instead of demanding perfection, accept what is good enough. The hospital system we had in 2008 was by and large good enough. Was it really necessary to destroy it in order to make it better?