I never understood this because other countries have free healthcare and we don’t! We get sick and it’s expensive to even pay for anything!
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Often it’s US health care funding the research and development. When we needed a new vaccine the world wasn’t holding their breath waiting for Sweden to create it.
Most countries pay less for medicine and medical supplies, they do fewer unnecessary tests on patients, they pay doctors and staff less, they don’t have so many middle men taking a cut, etc.
Obviously other countries are still paying through taxes, but considerably less per person overall than the USA pays.
It’s incredibly inefficient.
In single payer models there’s a lot less overhead. When you have a single payer, or centralized administration you don’t have the redundancy that you get in a silo’d marketplace.
The counterpoint is often in a marketplace you should see more competition and innovation because a market advantage should make you more profitable – however this is rarely the case. In actuality, as the corporations generally just continue to inflate profits where they can.
Additionally there’s the issue in the US that it’s only the user who pays. So there’s a much greater emphasis on the individual user. That is to say your individual insurance policy is funded at an individual level. Whereas in a shared more socialized setting the community pool funds the care. That’s just an americanism, in other parts of the world the burden is shared equally amoung the entire pool so everyone pays a bit rather than one person paying a lot.
It’s important to note almost every country I’ve ever looked at is a little bit different. I’m no expert, but I’m fairly well read on the subject, and the Canadian system, compared to the UK system, to the Swedish are all different from each other, with varying approaches on administration or functionality.
Edit – to clarify, I know that in American systems of insurance there are still funded pools not all individual, it’s just that there’s many more, and they are private pools, rather than a universal all community pool. And there’s the issue of deductible etc which applies sometimes in universal systems (albeit more rarely).
The free healthcare systems in other countries have built in cost controls. In countries with a free healthcare system, that cost control typically comes from the government allocating $X per year to healthcare and the system tries to divide that up as best it can.
The result of this is that a lot of high-cost treatments that are widely available in the US are either completely unavailable in other countries or have a small quota for how many treatments can be performed each year. A good example of this is basically any major surgery on an organ, heart attacks, or strokes. If you’re going to need/have one of those things, you really don’t want it to happen to you in Europe.
In Europe, high cost stuff like brain surgery has very limited quotas that result in most people dying before they undergo it, while many emergency treatments for heart attacks and strokes simply are not available. In the US, chances are you’ll be able to get scheduled for a major, high cost surgery within a month. Similarly, if you arrive at the ER conscious, your chances of surviving a heart attack or stroke in a modern US ER are pretty close to 100%.
The reason that high cost treatments are more available in the US is the same reason that healthcare is more expensive – there is no cost control. After you’ve paid your annual out of pocket maximum (which is usually $7,500 – $12,500), 100% of your healthcare is paid for by your insurance company. If you’re old enough for Medicare or poor enough for Medicaid, then 100% of your healthcare is paid for by the government (and neither Medicare or Medicaid has an allocation mechanism like government programs in other countries do – Medicare and Medicaid just pay 100% of any eligible bill that gets sent to them).
Because there is no cost control in the US, costs get out of control very quickly. Adding cost control into the US system is politically unfeasible because it means that treatments that formerly were available will no longer be available, either because of quotas or cost.
Because a large portion of the money you spend on healthcare goes to pay CEO’s, the rest of the c-suite, boards of directors, and shareholders (via dividends and stock buy backs).
Think of it as a Capitalism Tax. Or a Vampire Tax as you are paying blood sucking monsters that add nothing to your health care.
Profit. It takes a lot of money to run for and win an elected position, so in order to raise this money they need to take campaign contributions, and people who take contributions from more profitable industries and companies will have a better chance of winning their election. This is legal due to Citizens United (look that up)
Industries like Oil or Healthcare insurance make a lot more profit than green tech etc. So they can have a greater influence on politics.
And furthermore, companies that are typically competitors, e.g. different insurance companies now suddenly have a shared interest when faced with possible legislation that would impact their profits.
So the entire industry can react together and present a much more unified front that basically prevents any change that would affect the profit margins of a significant sector of an industry.
Your whole premise is wrong. There is no such thing as free healthcare, it is tax funded. Tax funded health care as a whole is expensive. It is just spread out. Also there is issues with level of service in the tax funded model. Many Canadians go to USA for health care.
In one word: Greed.
Single-payer systems uses master pricing lists to set the price of a treatment or service across the entire system. So, the pharmaceutical company can’t easily say no; otherwise, it would end up missing out on the market. Couple that with other factors, such as scale, simplified administration and a focus on patient outcomes over profits, and you have a system that isn’t incentivised to push prices as there are regulatory bodies keeping watch.
Hospitals set their prices high so they can offer big percent discounts to insurance companies. An uninsured person is given an astronomical bill which the hospital agrees to wave half or more. Then they write off the uncollected part as a loss on their taxes.
In the US, there is a whole industry of insurance companies, who hired people to deny claims, which means that doctors need to hire people to file claims so they won’t be denied.
Then you need lawyers to sue the insurance companies so they will pay.
Any time there is an adverse outcome, in the US, someone may decide to sue the hospital. Payouts can be huge. So the hospital needs to hire lawyers to defend themselves, which means malpractice insurance. Suing a national health system is much less common and probably much less lucrative.
So basically, for every $1000 spent on actual health care, in the US there’s another $1000 going into insurance, paperwork and lawyers. When I go to get an X-ray here in Canada, I walk in, show my health card, go in back, get x-rayed, and walk out. I don’t do any paperwork, or pay anything, and the X-ray people do minimal paperwork.
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