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Related: https://en.wikipedia.org/wiki/Health_system#International_comparisons https://en.wikipedia.org/wiki/Health_system#International_co...

• taurath 8y ago
  Thats a good quick chart I can use to pull up when arguing for a single payer system. I think the biggest problem with single payer in the US is cultural, not even political - people simply don't trust the national government to do anything at an acceptable level (except when it comes to defense, the post office (74% approval rating), and the CDC).
  • tptacek 8y ago
    How does this chart address the question of how we should fund our health care system? The problem is how much we're paying, not whether we pay for it in payroll taxes or out of pocket.
    • deogeo 8y ago
      The chart shows a strong correlation between government funded healthcare, cost-efficiency, and effectiveness - that's how.
      • tptacek 8y ago
        Correlation isn't causation. Switzerland's health spending is in line with that of Canada, France, and Germany, has roughly the same (better in some cases) life expectancy outcome, and is an entirely private system. Life expectancy is also a poor way to compare health care systems, because major factors decreasing life expectancy have nothing to do with quality or access to care --- for instance, one of the most significant hits we take to life expectancy in the US is the prevalence of traffic fatalities.
        • sethev 8y ago
          In Switzerland, the basic insurance plan is defined by the government and everybody is required to participate in at least that plan. Everybody has the same deductible and out of pocket maximum and premiums (as paid by individuals) are capped at 8% of income. If you don't sign up the penalties can actually be higher than premiums and if you persist in not getting insurance the government will sign you up and allow the insurance company to sue you for any unpaid premiums. This system is nothing like what "private" means in the US. This would be called communism in our current political discourse.
          • tptacek 8y ago
            How are you not describing the ACA system? The ACA makes health insurance compulsory (not as effectively as the Swiss system, to be sure), mandates a minimum health plan (quite effectively, and quite similarly to the LAMal), guarantees issuance, and prices through community rating, the same way the Swiss system does. US spending on health insurance is 6% of income, 8% if you include expenditures outside insurance. I'm not arguing the US system is better or even close to as good as the Swiss system. We have a lot of problems, and overpay flagrantly. I'm saying the Swiss have a system that closely resembles ours (unsurprisingly, since ours is patterned on theirs) and theirs appears to work. That tells me our problems are orthogonal to the issue of private versus public insurance. I think the weak penalties for not carrying insurance are a serious problem with our system, but you are going to have a difficult argument to make if you want to attribute the hundreds of billions of dollars we overspend in health care to just that factor, or even significantly to that factor.
            • sethev 8y ago
              Sure, it's similar (no coincidence, as you point out). Most people in the US don't directly participate in the ACA marketplace. For all the talk about freedom of choice, i'd venture that the majority of Americans have no real choice in what insurance they'll get (apart from their freedom to switch jobs or pay a higher price on the exchange by forfeiting their employer's contribution). We also have a significant population (~15%) on a public system that has an influence on prices that everyone pays but no authority to negotiate drug prices. I don't think that any one of these differences is an explanation for the gap between ~11% of GDP and ~17% but there are enough of them that it's hard for me to decide public vs private is orthogonal.