Cross-posted at Montclair SocioBlog.
The Washington Post has provided some data on medical costs across a selection of countries (Argentina, Canada, Chile, and India in grey; France, Germany, Switzerland, and Spain in blue; and the U.S. in red). The data reveal that American health care is very expensive compared to other countries.
No wonder the US spends twice as much as France on health care. In 2009, the U.S. average was $8000 per person; in France, $4000. (Canada came in at $4800). Why do we spend so much? Ezra Klein quotes the title of a 2003 paper by four health-care economists: “it’s the prices, stupid.”
And why are US prices higher? Prices in the other OECD countries are lower partly because of what U.S. conservatives would call socialism – the active participation of the government. In the U.K. and Canada, the government sets prices. In other countries, the government uses its Wal-Mart-like power as a huge buyer to negotiate lower prices from providers. (If it’s a good thing for Wal-Mart to bring lower prices for people who need to buy clothes, why is it a bad thing for the government to bring lower prices to people who need to buy, say, an appendectomy? I could never figure that out.)
There may also be cultural differences between the U.S. and other wealthy countries, differences about whether greed, for lack of a better word, is good. How much greed is good, and in what realms is it good? Klein quotes a man who served in the Thatcher government:
Health is a business in the United States in quite a different way than it is elsewhere. It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.
So we Americans roll along, paying several times what others pay for medical procedures, doctor visits, and drugs.
Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.
Comments 16
Yrro Simyarin — March 29, 2013
If medicine were actually run as a fair business run by normal principles of greed and risk, it would be much cheaper. In how many other businesses does the government directly subsidize a third party payer model to the point of driving out all reasonable incentives for actual competition? Every policy we have only drives prices higher. The new "reforms" only worsen this issue - premiums are already rising.
You can improve on bad governance two ways - less government or better government. It doesn't change the fact that bad governance is the basic problem.
Brutus — March 29, 2013
Government cannot set prices, because government cannot set costs. What a government can do is redistribute the costs to hide the price, or exercise some limited effects on cost.
There's a multitude of factors, among them a scarcity of healthcare providers, but the right solution isn't importing cheap Chinese doctors at government expense to provide low-cost appendectomies.
cmu — March 30, 2013
brutus, Govt. can and indeed does set prices. If Medicare says it'll pay x dollars for y service, it's 'setting the price' for y. And health care providers go along with it, albeit grudgingly. And please cite 'scarcity of health care providers'; I suspect it's the opposite.
The high price of care in the US as compared to others is due to many things, none of which is govt. interference: excess capacity of very expensive apparatus, the propensity for doctors/hospitals to want and buy the latest & most expesive equipment, the profits of the insurance companies, the high price of liability insurance, excessive cya testing, and to some extent, that administrators and speciality doctors are compensated very handsomely.
Competition in something like health care simply does not work.
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