So you want single-payer health care, Medicare for all

Listen to some politicians and single-payer advocates and you may get the impression that universal health care is the solution we seek. They often point out lower costs and universal coverage. The only thing that is generally true is universal coverage. 

While many Europeans think they have free health care because of little or no cost at the point of service, that is quite misleading. In Germany for example, the real cost is 15% of payroll half paid by the worker. Other countries are similar. When the government pays the costs, it is funded by a variety of taxes including the VAT of up to 22% in a sales tax.  [NOTE: Every European I have talked with in several countries were happy with their health care system.]

The US does spend, as a percentage of GDP, considerably more than other countries, but there are many reasons for that including the American health status and lifestyles, the level of health care services available and the expectations of Americans. 

We may well be headed for a single-payer system (out of frustration), but there is no free lunch. There will be major costs and major changes in how Americans view and receive health care. 

Proponents of single-payer health care must give the full story to the American people. 

Typical characteristics of European health care systems (not all apply to all systems):

😷 An annual budget for health care spending

😷 Assignment to a specific hospital

😷 Limited choice of doctors 

😷 Government determined covered drugs

😷 Generally three or four patients to a hospital room

😷 Waiting times from several days to weeks for CT scans and similar procedures 

😷 Waiting times measured in months for non-emergency surgery 

😷 Waiting times of several weeks to a few months to see a specialist 

😷 Budget constraints creating shortages of facilities and health care professionals 

😷 Government committees that evaluate the cost/benefit of certain procedures to be performed on individuals with the ability to deny the procedure

From a Columbia University study:

The US does hold certain advantages over UK when it comes to the private healthcare sector. For instance, the US rates 40% higher than the UK in percentage of men and women who survived a cancer five years after diagnosis. The US also ranks higher in percentage of patients diagnosed with diabetes who received treatment within six months. The number of US patients who received timely treatment for diabetes was more than 6 times that of the UK, and twice that of Canada. Similarly, the percentage of US seniors who received hip replacements within 6 months of diagnosis of need is more than 6 times that of UK and twice that of Canada. Finally, the percentage of seniors (Age 65+) with low-income who say they are in “excellent health” in US was far and away greater than that of any other nation.

“In other countries that have more centralized prices, those sorts of price disparities don’t really occur,” Squires said.

Such systems also wield much greater control over what kinds of medical procedures, medications and therapies are available to consumers. They conduct cost-effectiveness reviews to decide if a given service is worth the investment of limited health-care dollars, said Cox at the Kaiser Family Foundation. Source: SanDiego Union Tribune 3-18-17

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