There is simply no doubt in my mind that GovCare in the US would be expensive and inefficient. Public sector salaries and benefits far outpaced those of the private sector, which is terrible. Now, we are on the way to have a major expansion of the public sector economy.
Proponents of the single payer systems are right -- the only way this "government expansion reform" may make sense is if private insurers are eliminated, and fee for service system is out, and everyone in healthcare is on salary, in some form or another.
Medicaid is the only program (besides the VA system) which is largely run by the government, and it is financially a chronic disaster. They are scrambling to get costs under control by signing up beneficiaries with private HMO's. Medicare is not far behind, even though it is administered through a network of private insurers.
Europe has a centuries long tradition of big strong centralized governments - we do not. Maybe the Euro's are capable of running an acceptable GovCare system; in the US there is zero evidence that our politicians can do it. Regret to say, but it's going to be a big disappointment -- an unnecessary great leap leftwards. And it may not be easy to dismantle - there will be big constituencies with a vested interest in keeping it going.
Deregulation, simplification of the system, removal of barriers, tort reform, getting politicians out of the way as much as possible - all this would make healthcare more competitive and transparent - and likely, more cost effective and accessible. What they did is the opposite. |
