It is part of the cheaper. But single payer as opposed to 1000's of employers working through 100's of profit driven insurance companies, and all the paper work, profit, managerial salaries, inefficiency and marketing that that entails, stands alone as a "cheaper" argument. Our system is convoluted and dysfunctional, and as a result consumes 15.2% of GDP compared to less than 10% on average for countries with universal health care.
We don't spend 5+% of GDP on processing health insurance claims. Your trying to lump all the difference is costs in to that factor is just silly.
Bigger sources include different prescription drug prices, differences in legal climate (both the direct costs of malpractice suits and claims and insurance, and the larger cost of more "defensive medicine), higher doctor's salaries, and just the fact that we are wealthier then most other countries (even than most Western European countries, and Canada). Health care beyond the most basic is economically a luxury good, demand climbs with income. And its even harder to sate then the demand for other luxury goods (a rich man might not want to spend a lot of money to buy his 16th yacht, or 12th Ferrari, or 400th wide screen TV, but he'll spend whatever it takes to try to save his life)
Tim, let me ask you this. If you were "designing" a society from scratch, and looking at health needs, would you have employers on a voluntary basis providing various levels of health insurance?
I wouldn't design the system. I'd let the companies decide what they want to do. But I wouldn't have given them the incentives (tax advantages today, and even large advantages in the early days) that caused many of them to start doing so.
*A "free market" solution? You would have to make it illegal for companies to provide health insurance.
No you wouldn't, you would only have to stop giving special tax breaks for them doing so. Making it illegal would be moving away from a free market system.
*A single payer system? We can get there if we can overcome the industry lobby groups.
Its not just the industry lobby groups that are in opposition.
More and more companies are supporting national health care because it would make them more competitive internationally and remove a tremendous cost burden.
The supporters are mostly those who foolishly agreed to provide to high of benefit level (to retirees not just current employees) and now would like to be bailed out.
Instead of looking at it through an ideological lens, look at it through a pragmatic lens. How can we make it incrementally better?
Reduce government involvement in it, specifically look for the worst cases of government intrusion, subsidy, and regulation, and trim those out, that would be incrementally better, without the complexity, political difficulty, and "ideological lens" of more wide spread reform. Changes could include tort reform, and an end to government incentives for providing insurance. Thats looking at incremental improvement from government action. Many other improvements would have to come from private sector action, its not all about what the government does or does not do. |
