The Wall Street Journal notes that, just as ours is, the German healthcare system is under stress:
Germany’s health-care system was brought to life in 1883 by Otto von Bismarck and became the model for virtually every such state-directed national insurance plan since. Alas, the German system is starting to come apart at the financial seams. Germany’s system relies on a handful of state-supported health insurers. This week they informed the government that the system was on the brink of a financial shortfall equal to nearly $11 billion.
Pointedly, the insurers made clear that cutbacks alone won’t solve the problem. They said the government would have to consider raising premiums on the insured or, you guessed it, raise taxes. Currently, German workers pay a fixed-rate premium into the insurance scheme; that rate is now set at 14.9% of gross pay.
As the graph at the top of this post illustrates costs are rising fast in the British and French healthcare systems, too.
The Dutch healthcare system is sometimes held out as a model for the sort of reform that we need in this country. I think there are lots of reasons to be skeptical about that. The current Dutch system was only adopted in 2006—too recent to draw any conclusions. Dutch healthcare is organized differently from ours: primary care providers are central to their system and the median income of GP’s is higher there than that of specialists (as high as it is here). Finally, the Netherlands is significantly smaller than the United States with considerably more ethnic and national identity, more solidarity, than we have. That affects willingness to pay.
There are basic issues of belief and social cohesion that are different between France, Britain, Germany, the Netherlands, and the United States. A universal healthcare system, whether one like British National Health or one like France’s Assurance Maladie Universelle, operates with some assumptions. First, the people must be willing to pay for other people’s healthcare, even people whose incomes are higher than their own. Second, physicians must be willing to accept the levels of pay that would make such a system sustainable.
I think those two requirements are prerequisites for such a system and antecedent to such a system rather than a consequence of it. Will American taxpayers be willing to pay for a system of universal healthcare? Will American physicians be willing to work under one? It’s beginning to look increasingly doubtful that German, French, or British physicians are.
Where’s your proof for this? There are escalating costs in every system except Japan’s ( including the US, although that Wall Street Journal article doesn’t mention that their increases are still smaller than the increases in the US system), but I haven’t seen any proof that it is due to high and increasing demand for higher pay from physicians, as opposed to other factors (like a rapidly aging population, as well as the costs of new medical equipment and treatment).
The proof is in the graph and the multiple links in the body of the post. “Healthcare costs” aren’t some abstract thing with an identity of its own. It’s composed of things like pharmaceutical prices, the cost of building the physical structures in which healthcare is practiced, and so on. But the overwhelming preponderance of healthcare costs are wages. In one form or another it’s, at the very least, a majority of the costs.