Leaving aside from the fact that very few countries have wholly-government owned health care - this formulation doesn't make sense.
Or is it the line about gouging you are referring to?
Can you explain a bit more clearly what your point is? I haven't woken up enough yet to decipher your comment.
> This may be the primary reason why health care in most civilized countries costs half of what it does here.
There is a common conception that simply adopting one of the many different systems used in these other countries would immediately solve the cost problems in US healthcare by way of single payer price negotiating, but the problem that addresses doesn't tell the whole story of high healthcare cost in the US.
It's not just US healthcare costs that are abnormally high but healthcare consumption - due in part somewhat to the defensive posture of medicine towards a tort heavy society, but also because healthcare consumers in the US simply demand more healthcare than consumers in other countries; (call it the Super Size Me effect?)
So it's not necessarily the case that any kind of single payer system is going to change that culture of consumption. The systems used in other countries are largely possible due to different levels and modes of consumption.
Mind you, I generally support some kind of single payer system for the US (preferably modeled after some combination of elements from Canada, France and Australia). But I'm bothered by these panacea arguments when it doesn't seem at all clear that such statements of causality can be convincingly made.
The thing is that single payer healthcare systems in Canada and Europe aren't necessarily owned by the government. In Canada, each province's healthcare is run as a government owned insurance company, with the requirement that everyone have health insurance. Some provinces bill this out to each insured person on a sliding scale of income, with a cut off for the low income.
It's not, because other countries with mixed public/private systems don't have notably higher costs than the full- or primarily-public ones.
Healthcare hasnt been so expensive forever, it was actually very cheap decades ago, when it was still private. The efficiency issues are not public vs private. Its mostly regulatory burdens.
How could that possibly be a free market system/.
The government itself barred Medicare from negotiating drug prices. If it is incapable of overturning such a policy, why should it be entrusted with 10x more patients?
> So how would you have the government setting prices and reimbursement rates and not have a higher "regulatory burden"?
You could have the government give a health-stipend for insurance for all americans, so its government funded, kind of like school vouchers. Today medicare instituted fee-for-service, which means you have to document every procedure you do and you get reimbursed based on that, which I believe is the core reason why there is so much red-tape in Healthcare.
This would allow all patients to choose which insurance fits best, and unleash major competitive forces on price.
The political faction which opposed and supports the policy you point to does so for precisely the same reason it is opposed to the faction proposing single payer; people voting for the faction that supports single payer would also vote out the faction supporting that policy. So, you are literally conflating two opposing things as the same thing.
> You could have the government give a health-stipend for insurance for all americans, so its government funded, kind of like school vouchers
Yes, and if you also have the government provide a default fully-public-funded option just like with school vouchers, you will have almost exactly recreated what Medicare already does for it's covered population (Medicare Parts A & B are the public option, Medicare Advantage plans are the private options to which public “voucher” subsidies can be applied in place of the default public option.)
I disagree, but regardless of that appreciation the problem exists today when its smaller, if you had single-payer it will be a harder problem to fix.
> Yes, and if you also have the government provide a default fully-public-funded option just like with school vouchers, you will have almost exactly recreated what Medicare already does for it's covered population
It was an example to show how high government participation can lead to low regulatory burden, not an actual intended recipe for the US and its current or proposed system.
Also, while most countries have healthcare that is payed for by the government having the government run healthcare is also fairly uncommon. I know Canada, the UK, and Singapore have public provision but most countries have public payment and private provision.
You can manage the problem of pre-existing conditions in an insurance system with a subsidy, instead of a mandate that forces a 20 year old minimum wage person to work part time, because the employer cannot afford to pay healthcare for him.
There has never been a law in the US limiting the number of doctors available.
tying healthcare to the employer, etc.
There was never a law tying healthcare to the employer. Before the ACA, if you had a preexisting condition, that was the only way that you could get insurance - by being part of a covered group. The insurance company wouldn’t cover you.
You can manage the problem of pre-existing conditions in an insurance system with a subsidy, instead of a mandate that forces a 20 year old minimum wage person to work part time, because the employer cannot afford to pay healthcare for him.
So we need universal coverage like the rest of the civilized world....
My understanding is that the supply of doctors is limited by the amount of residency slots and that is limited somehow by whatever professional association licenses doctors.
There is at least one such limits to about 1/4 of 65.000. And even within that limit they have an irrational amount of extra requirements.
> There was never a law tying healthcare to the employer.
Sorry but in the US, health insurance is provided by the employer because it is a tax-exempt expenditure. Tax it and see wages diminish considerably once employers pass the cost to the employees.
> So we need universal coverage like the rest of the civilized world....
The uncivilized world also has universal coverage. That should be a red flag, shouldn't it?
Employers already pass the cost to employees through lower wages.
The uncivilized world also has universal coverage. That should be a red flag, shouldn't it? reply
Yes, that in this regard the US is worst than a third world country...
And you would be very wrong to believe healthcare in the us is worse than in third world socialized medicine countries. You will find horror stories galore as well as all other kinds of trade offs you wouldn’t accept.
The phrase 'doubling down' comes to mind here.
To judge the correctness of your statement, just look at what has happened to other industries that the US Federal Government controls: costs rise, service times increase, quality suffers, accountability disappears, etc.