Steve Burton makes an excellent point: The amount of public per capita spending on health care in the United States (Medicare, Medicaid, etc.) is actually more than the amount spent by the governments of Britain, France, Canada, Sweden, and other similar countries. To be clear: That's not counting any of the billions of dollars spent privately in the United States. Burton then asks an obvious question:
So here's my question: why do we get so much less bang for our public buck than anybody else? All of these governments spend less than ours does, but somehow they manage to get virtually universal coverage out of it. Our government spends more, yet only covers the old, the poor, and veterans. What gives?
The explanations offered by Krugman and Wells are simply beside the point here. Administrative costs? They praise Medicare's efficiency. Ability to bargain with suppliers? They point out that "both Medicaid and, to an even greater extent, the Veterans' Administration, get discounts similar to or greater than those received by the Canadian health system."
Again: what gives?
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Krugman & Wells are not alone. Leftish discussions of healthcare often suggest that if only we would abandon the few remaining trappings of the free market that continue to plague our system, then we could enjoy French-style outcomes at French-style cost. 'Cause the main factors that are driving our costs up are the sort of market-related inefficiencies singled out in the article cited above.
But, if that were true, and the public part of the American system all that efficient, wouldn't it already cover everybody for what it is already spending?
If not, why not?
I'm looking for an honest liberal. A liberal who will admit that the high cost of American healthcare is not primarily explainable in terms of the administrative and advertising costs of the private side of our healthcare industry.