You’ve got to get to the second to last paragraph in Ed Dolan’s defense of Bernie Sanders’s healthcare reform plan,into the fine print as it were, before you get to the real problems with our healthcare system and why reforms that only target how care is paid for are inadequate:
Another reason for the higher cost of US healthcare services are higher earnings of physicians. US doctors earn considerably more than their European counterparts do, even when we adjust fees for differences in expenses and cost of living. But changing compensation practices for American doctors would not be easy without reforming other pieces of the healthcare complex. European doctors typically receive free education, so they don’t begin practice with tens or hundreds of thousands of dollars in student debt. Entry into medical schools is not as tightly restricted in Europe as in the United States. And less adversarial systems to deal with malpractice claims free European doctors from a major cost item while giving them less incentive to practice unproductive defensive medicine.
Additionally, although they do exist in Europe for-profit hospitals are something of a rarity there and in the United Kingdom.
Incremental reforms or reforms that only affect the payment end of the healthcare system aren’t enough. If you really want to reduce costs, you’ve got to change the whole system at once in pretty basic ways. Which is why we haven’t done it.
When I worked as an engineer at Siemens, Munich, I was able to avoid health insurance altogether once I registered as “freiwillig versichert.”
I shudder think that wage (and price) controls should infect doctor salaries. It’s worked out so well elsewhere. Do I get to dictate salaries for rappers, Hollywood actors and second rate third basemen? The other points seem sensible.
I’m not a hospital financial analyst, but figures I’ve seen show margins pretty much suck. Not sure there is much in profit to squeeze there without addressing expenses and demand.
Guarneri:
Physicians’ salaries in the U. S. aren’t where they are now due to market forces but due to the subsidies they’ve been receiving for the last half century. Look at any graph of physicians’ salaries since 1965. They can’t be explained by market forces, productivity, or anything other than government intervention.
What the federal government hath given, the federal government may take away.