The lack of self awareness is astonishing

Many liberals and a growing number of Democratic presidential candidates have embraced a bold idea for reforming America’s broken healthcare system. The idea most in vogue—and the most debated—throughout the 2020 election has been to abolish private insurance in favor of a government-run national system, otherwise known as “Medicare for All.” Advocates of “single-payer” generally blame rapacious insurers as the principal villains of the current system, responsible for sky-high premiums and out-of-pocket expenses. Replacing for-profit insurance companies with a government program, the logic goes, would bring lower costs and coverage to everyone

But this singular focus on insurers means that the presidential hopefuls are neglecting an even bigger problem with far-reaching consequences for millions of Americans: the dominance of hospital monopolies in a growing number of health care markets nationwide.

Monopolies, in general, mean bad news for consumers. Health care is no exception.

That’s why there should be a single, monopoly, health care system like Medicare for all, right?

Competition, not consolidation, is better for patients.

Err, yes?

20 comments on “The lack of self awareness is astonishing

  1. I think they don’t count it as a monopoly if it’s run by the government – because we all know the government are great at doing things on time and in budget and competition with the government is evil…

  2. Replacing for-profit insurance companies with a government program, the logic goes, would bring lower costs

    Which logic is that? Ideas like this were discredited in about 1960.

  3. ‘broken healthcare system’

    False characterization. But if you repeat it enough . . . .

    Government has mucked up U.S. healthcare. The obvious solution is to put government in complete control.

    The Left doesn’t care about your health; they want control. Nationalized health care would grant them massive control over the people.

  4. I wouldn’t have the brass neck to tell the Yanks how to organise their healthcare but I will tell them how not to do it: don’t copy the NHS.

    My instinct is that they might usefully experiment with competitive markets rather than the strange, corrupt, crony capitalism that seems to flourish at the moment. But I shouldn’t dream of urging that policy on them.

    Naturally such markets would have to be designed to cope somehow with asymmetry of information. And the market distortion of offering free emergency care to whoever rolls up. And the fierce American shyster trade. And the bruited Dem Party policy of providing free healthcare to any citizen of anywhere who can successfully cross into the USA. Coping with that last one would be a real challenge. Good luck, chaps.

  5. I’m not an expert by any means, but ISTM that the US system is blighted by their legal system. They overtreat to avoid being sued, which costs every which way.

  6. Always when Brits talk about health schemes we end up comparing the NHS with the US system. In reality, neither is very good. The NHS for patchy quality, the US for runaway costs. Somewhere in the world is an optimum solution. Find that and copy it. Don’t overthink it, copy it as near as you can.

  7. Lack of self awareness eh …. France often tops the league when health systems are assessed and the WHO estimates spending per capita (2015 USD ) as 4026. The less successful UK system was 4356 and the USA 9536. Top of the world ma !
    The US has consistently ranked below most developed nations but it’s worse than that. While the US spends a vast 8.8% of GDP on private health care picking up the slack it also spends 8.5% of its GDP on health out of public funds, roughly equivalent to the average developed country .(2016)
    So the USA is on the face of it a terrible system
    Expensive or both tax payers and Premium payers
    Inefficient
    Patchy allowing brutal and unfair suffering
    Stressful – are you insured for that or not?

    It could not be worse and it is usually beaten into the ground by monopoly public sector providers.
    To understand why US Health Care is so terrible you have to also understand key exceptionalisms about the US but if post about “Self-Awareness” and base it on the self-evident superiority of the Commercial System. I think you may need to get out of your right wing echo chamber ( for the good for your health )

  8. The French system isn’t a ” monopoly public sector providers.”

    Nor is the German etc

    Dingbat.

  9. Somewhere in the world is an optimum solution. Find that and copy it. Don’t overthink it, copy it as near as you can.

    +1
    Actually, you could stick a pin into a map of W Europe and say “we’ll just copy the health system of that country” and you’d end up with a system substantially better than the NHS.

  10. Didn`t say it was( although it is largely ), but the UK is (close enough) and it also thrashes the USA .The state licensed for profit part of the French system is only outsourcing anyway France provides universal cover with only token pricing. Anyhoo whichever way you look at it the most private system is the worst
    Just relax sir it will hurt less that way ..and now cough ”

    XX

  11. Facepaint–America is not the “most private” numbnuts–medicare, medicaid, the fucking doctors trade union–still has success rates way above the blot that is the NHS.

    Nor are the European systems anything to do with your precious EU you sack of festering turds.

  12. “Didn`t say it was( although it is largely ), but the UK is (close enough) and it also thrashes the USA .The state licensed for profit part of the French system is only outsourcing anyway France provides universal cover with only token pricing”

    What was that sound? Oh, it was Facepainter getting something wrong on the Internet again… How can you begin to fisk this artful blend of nonsense, blethering bullshit, and remarks so vaguely and ambiguously expressed that there might be a kernel of truth in there, as long as you are prepared to give him the benefit of the doubt? On the other hand, it’s quicker just to dismiss it as mendacious bullshit

  13. “ Actually, you could stick a pin into a map of W Europe and say “we’ll just copy the health system of that country” and you’d end up with a system substantially better than the NHS.”

    The problem is path dependency, how did we get here to understand the politics and then how to get from here to there both politically and practically. Even in the unlikely event of having political will, something even Maggie couldn’t achieve, its hard to see a practical path to anywhere else. That’s why we have an unfunded welfare state, Bevan wanted fully funded state pensions but was overruled because it meant so many missing out.

    PS Singapore is claimed by many free market thinkers, including our host IIRC, as being the best system.

  14. I only introduced France, actually, as a point of comparison to show how much more the US spends than a developed country with a generally well regarded health system.

  15. Many liberals and a growing number of Democratic presidential candidates have embraced a bold idea for reforming America’s broken healthcare system.

    The same people who (a) told us Obamacare would successfully reform America’s broken healthcare system, and (b) defended Obamacare as being completely successful up until the moment Donald Trump won the presidency.

  16. I only introduced France, actually, as a point of comparison to show how much more the US spends than a developed country with a generally well regarded health system.

    If you travel along the US side of the US-Canada border, what you will notice is just how many large private hospitals there are… all filled with Canadians paying out of pocket for our inefficient and expensive health care services.

    Why is that?

  17. You shouldn’t be measuring the quality of a health service by how much is spent on it, but by how good it is. The constant cries of “we must spend more on XXXX” I counter with “why? We need to spend *less* but *better*.” The “spending more is better” mantra would mean that I was still spending £10 per kilobyte on memory and 20p per minute on telephone calls.

  18. Given the EU ever closer union, European empire vision is always found it odd the screams over a HS trade deal threatening the NHS when it’s the EU that’s most probably a bigger threat. Health is such a big market I can’t see the EU apparatchilk staying our
    If it for ever.
    I’m near the Canada US border and the only people I know that have been to the US hospitals have been for elective/cosmetic treatment

  19. Newmania:

    “Lack of self awareness eh …. France often tops the league when health systems are assessed and the WHO estimates spending per capita (2015 USD ) as 4026. The less successful UK system was 4356 and the USA 9536. Top of the world ma !”

    Actually, no. There is an even worse health system out there: Bermuda’s, with per capita spending of $11,952 per annum.

    Combining the worst of the British and American systems, Bermuda’s hospital is publicly owned and funded, yet charges for use at prices even higher than American hospitals. Thus, Bermudian residents pay three times for healthcare: once to build the hospital, a second time for compulsory government medical insurance, and a third time when they actually use the hospital or buy top-up insurance (since the government scheme has as many holes as a colander).

  20. Newmania
    France has a good health care system?
    So that must be why the French don’t trust their doctors (quite correctly in my experience) and are the world leaders in consumption of quack remedies.

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