As I have said many times before, Paul Krugman doesn’t know anything about health care. Here he is writing in The New York Times:
“Consumer-based” medicine has been a bust everywhere it has been tried…… America has the most “consumer-driven” health care system in the advanced world. It also has by far the highest costs yet provides a quality of care no better than far cheaper systems in other countries.
To which Megan McArdle replied: if consumer-driven care means more out-of-pocket spending, the US is in the middle of the pack. See the graph:
And if it means people choosing their own health plans, Switzerland is the world’s leader on that score. As Tyler Cowen pointed out, Krugman himself praised the Swiss system in an earlier editorial.
You have been right many times before: Krugman doesn’t know anyting about health care.
The U.S. health care system is about as socialized as any around the world. The difference is only half of medical care is socialized through government spending. Another third is socialized through employers. We only pay about 12 percent of our care directly.
Switzerland offers putative health plan choice but in reality the plans are pretty much the same–a lot like the “choice” offered in the Massachusetts Connector Authority.
By comparison to pre-ObamaCare US health plan choices on the individual market in lightly regulated U.S. states, the Swiss have no consumer choice.
So Krugman is intellectually dishonest. What else is new?
Former Enron advisor Paul Krugman has made it his mission to be an acolyte for the Democratic National Committee, alongside his host the New York Times. From that starting point, he contorts arguments in favor of every Nanny-State initiative put forth by the Democrats, and arguments against every anti-Nanny-State initiatives put forth by anyone else. And then he tops it off with arguments that anyone against the Nanny State is e.v.i.l. Everything else he says is minor commentary.
Londa Gorman, I agree with you as always. However, I think we have to accept that we are challenging a principle that appears to be universal in advanced democracies (outside the U.S.): The voters will not tolerate medical underwriting. If a plurality of citizens decides that nobody should be denied coverage because of a pre-existing condition, et cetera, the Swiss system may be the best we can hope for. (I realize that I’m throwing Professor Mark Paully and Professor John Cochrane under the bus here, but this does seem to be the way health care evolves politically.)
I was interested to see Canada spends (slightly) more out of pocket than U.S. does.
I am surprised that US isn’t on first position. The new trend for telemedicine and comfortable treatments makes the wealthier people pay for their own health instead of using insurances to pay for minor health problems.
You may find my additional analysis of Mr. Krugman’s commentary of some interest. There are many other aspects that go into “being a consumer” that Mr. Krugman has ignored, and others about Medicare itself of which he is clearly ignorant. It’s on-line at http://www.roadtohellth.com/.
Before you go into a frenzy of self congratulation, how about a chart that shows out of pocket in terms of median income>
Innovation costs money… We seem to have won that race and our cost/capita is a reflection of that reality. At the same time though, the innovations are immediately shared across the world. Now I know this is a rather generalized and seemingly unreasonable statement. If you take pharma out of the picture though, the CT machine used here is the same as the one used in Germany. The clinical practices and protocols innovated here get used in Australia.
Notwithstanding there are socio-economic differences to be taken into account. While we are criticized for our cost/capita being so much greater, relative to the health outcomes of other countries, there is never any rhetoric on the health in these other countries being bolstered by the spend in the US.
Just a thought…
Well Alyn, the CT machine we use here was invented in England, the land of the National Health Service. Our main “innovation” is spending more and letting less than every other western democracy.