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by monodeldiablo 3514 days ago
Most Western health systems are universal and more or less exclusively government-funded. This means that the entire population is in the same risk pool, reducing costs for the more vulnerable users and increasing the incentives to implement more preventative medical practices. As de facto monopolies, these systems can do a much better job of controlling the costs of salaries, equipment, and drugs. And, because the systems don't need to turn a profit, they can operate at cost.

Our private health care system, however, has a cycle of perverse incentives -- employers, insurers, patients, and doctors -- that leads to spiraling costs with no increased benefits. The populations with the highest health risks (i.e. costs) are shoved onto the public rolls, in the form of Medicare, Medicaid, and the VA. Meanwhile, the lowest-risk populations are forced to pay into private, for-profit insurance schemes. Specialists have outsized bargaining power, which leads to grossly outsized salaries. Equipment and drug manufacturers can play hospitals and systems off of each other to bid up prices. And, of course, shareholders want a return on their investment.

This problem has everything to do with economic and tax policy in the US.

1 comments

I think the point I was trying to address was the implied claim that we "can't afford" health care systems akin to other western examples. Arguments like:

> "Your tax rate is so high America would never vote for a similar tax."

> "Percentage wise those countries spend a lot more on health care than the US."

I would agree that our private health care system has perverse incentives. Combined with the degree of separation between cost and consumer due to our insurance system, this has resulted in general market failure.

Neither of these are directly economic or tax policy related (IMO). We already are being taxed and paying for health care...the issue is where is our health system failing to deliver value-per-dollar spent. Which generally might involve some economic policy overlap as far as market regulation, but I don't think it is the whole (or even the majority) of the story.