The American health care system is not driven by quality of care or establishing a baseline of health for all people. It is fundamentally about making more money than the competitor providers. Why? It is a business before anything else we want to call it.
Yglesias wonders about the Swiss model and the absolute failure of the current GOP to come up with any reasonable alternatives other than harsh criticism and fear mongering using the word "socialism" to scare people into a myopic deconstructive effort that fails the pragmatism test at every corner. If not the Obama plan, then what? The same plan that has not made any significant gains to improve infant mortality, health care related bankruptcies, and life expectancy even though it is more expensive than any other system that simply outperforms it on at least these important variables? Riding out in a system that is under-performing its cost is horrible business. But this seems to be the GOP "strategy" these days. Deconstruct with ad hominem rather than reconstruct with intelligent alternatives.
I wonder about the Japanese system. There the government role is primarily to control costs (and they do it almost too well since hospitals are not making a sustainable income in at least half the cases) and offer incentives to practitioners who have the highest rates of patient health – similar to the UK. The difference is that in Japan the practitioners are private. But I think no one in the US would ever support a non-profit model of health-care. Its a business to us and like all business someone has to get screwed if the business is going to make a better profit than the other guy. High costs are a good thing and fill the pockets of everyone but the consumer of health care.
Profit is why no economy will self-regulate and why the health care system here will not succeed in making our life-expectancy and infant mortality competitive with nations like Japan and the UK. In Japan, doctors are not some of the richest people in society. But there you can get cheaper tests, quicker visits to practitioners, and universal access in the second most wealthy nation in the world as vigorously capitalist (and I would argue more intelligently capitalist) than the United States.
Once the for-profit foundation of health care is removed with price control first, the game changes. But Americans giving up profit in order to save more lives more cheaply and more effectively? No way. That would be "uncivilized."
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