Paul Krugman compares Britain, Australia and Netherlands health care systems:
"Look at the latest report by the nonpartisan Commonwealth Fund, comparing health-care performance among advanced nations. America is at the bottom; the top three performers are Britain, Australia and the Netherlands. And the thing is, these three leaders have very different systems.
Britain has true socialized medicine: The government provides health care directly through the National Health Service. Australia has a single-payer system, basically Medicare for All — it’s even called Medicare. But the Dutch have what we might call Obamacare done right: individuals are required to buy coverage from regulated private insurers, with subsidies to help them afford the premiums.
And the Dutch system works, which suggests that a lot could be accomplished via incremental improvements in the ACA, rather than radical change. Further evidence for this view is how relatively well Obamacare, imperfect as it is, already works in states that try to make it work — did you know that only 5.4 percent of New Yorkers are now uninsured?
Meanwhile, the political logic that led to Obamacare rather than Medicare for all still applies.
It’s not just about paying off the insurance industry, although getting insurers to buy in to health reform wasn’t foolish, and arguably helped save the ACA: At a crucial moment America’s Health Insurance Plans, the industry lobbying organization, and Blue Cross Blue Shield intervened to denounce Republican plans.
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A far more important consideration is minimizing disruption to the 156 million people who currently get insurance through their employers, and are largely satisfied with their coverage. Moving to single-payer would mean taking away this coverage and imposing new taxes; to make it fly politically you’d have to convince most of these people both that they would save more in premiums than they pay in additional taxes, and that their new coverage would be just as good as the old."
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