While I can fully agree that a lot of the costing that happens in health care is opaque and quite…
John Whitling
1

I quite sure that no involved parties would advocate even an attempt at this concept.

That’s why I said it was a thought experiment.

That is why all these other countries that offer care superior to ours by just about every metric yet operate at half the cost. Most are not perfect systems. No large multi player market is. However, you cannot argue with the results versus our own.

I believe that you’re misreading the data.

Other countries outperform us on public health outcomes only because we have a much higher rate of uninsured individual in the sample. If you compare ONLY our insured to those other nations, our public health outcomes are roughly the same.

This means that their Ability to Deliver Care is not better than ours, as you suggest; it means that their Access to Care is better than ours.

This is better illustrated by critical care outcomes, where we easily exceed the rest of the world. Even with our uninsured population factored in, we tend to outperform them on outcomes. Again, compared insured vs insured, and you come to the conclusion that our ability to deliver critical care is unsurpassed. (The famous/infamous UN report that ranked us 37th in the world in public health outcomes also ranked us 1st in critical care outcomes.)

And that’s the “rub” when it comes to some (not all) of the health care proposals that have been made. In other nations, being a doctor does not make you rich, generally speaking; their ability to earn is often limited by the social insurance system they are operating under. (I have a nephew who is a physician in Sweden. He’s not rich, and never expects to be. He will eventually, with experience, settle comfortably in the upper middle class. Today, as a young physician…….well, suffice to say that he has to mind his kronor rather carefully.)

So, part of the reason those nations “operate at half the cost” is that they pay their providers (not just doctors, but nurses and med/techs) less. (Nurses in some countries earn less than we pay our teachers, relatively speaking.)

In the US, doctors tend to be in the upper income classes. Nurses and med/techs also can earn extremely comfortable paychecks, in most cases, relative to training. This incents our “best and brightest” to go into medicine, which is what you want, since its one of the reasons we have outstanding critical care outcomes.

I don’t know what insurance system we’ll end up with in the US, but if it limits the earnings of our health care professionals, count me out.

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