David Brooks today argues that a bottom-up approach to healthcare cost-control is more likely to work than top-down. I sincerely wish that were the case. Alas, it seems to me that the patient-as-consumer model just doesn't work in healthcare for reasons laid out here and here. There is competition among health insurance plans now – for companies to pick from – and the result is still far, far higher costs than abroad, with no better end-results. Ezra Klein compares costs:
Atop our giant government health-care sector, we have an even more giant private health-care sector. Altogether, we’re spending about 16 percent of the GDP on health care. No other country even tops 12 percent. Which means we’ve got the worst of both worlds: huge government and high costs.
Aaron Carroll adds:
The health care systems in the chart above all employ varying levels of private insurance. What they do have in common, however, is significantly more government involvement. There’s more government regulations, more government cost controls, more government negotiation. In our country, many are pushing the other way. They want more privatization and less regulation.
Look at the chart. They’re all beating us. They have far cheaper systems. Their outcomes are similar to ours, often better. And they cover everyone.
(Chart from Kaiser)
The Dish 