The current proposals for health-care reform being negotiated in Congress are better than what we have. But even if we should get health care with a public option and adequate subsidies, cost containment will probably be only at the margins.
- We pay our doctors about 50% more than most comparable countries.
- We pay more than twice as much for prescription drugs, despite the fact that we use less of them than most other countries.
- Administration costs are about 7x what most countries pay.
- We perform about 50% more diagnostic procedures than other countries and we pay as much as 5x more per procedure.
We can jabber all we want about incentives and greed and systemic waste, but the bottom line is that if we want to do anything more than nip around the edges, we’d have to pay doctors and nurses less, pay pharmaceutical companies less, pay insurance companies less (or get rid of them entirely), pay hospitals less, and pay device makers less. That’s a lot of very rich and powerful interests who will fight to the death to prevent any serious cost cutting, and it’s why Obama and the Democrats in Congress have largely chosen to buy them off instead.
It is likely that, even if health care reform passes, we will be grappling with costs for many years and will have to constantly revisit the politics of health care reform in order to get universal coverage with substantial cost containment.
