I am far more concerned about the huge cost of healthcare than I am about the quality of care here.
We have the 37th worst quality of healthcare in the developed world.
These numbers are really not very informative for several reasons, including the huge effect nutrition, vaccination, welfare, drugs, the car culture, have on children in this country.
In part we pay more because we subsidize R&D used around the world. Almost every major new technology and drug in my life time has been commercialized in the USA.
The other cost issue is that we pay for things in nutty ways. We use ERs @ $1000/hrf where other countries offer walk in clinics at night and weekends. We may have the best ERs in the world but treating an ear ache with an F22 makes littl4e sense. We offer "free" care to the indigent but hide the costs of that care in our insurance bills. We incentivize physicians to do procedures rather than care for patients after putting them into hundreds of thousands of dollars of debt to become physicians.
Our family structures no longer provide for care givers for the elderly.
Finally we have developed a myth that "preventative medicine" will save money. That is utterly wrong, at least for adults. We all get sick and die. The total care we need to get to that point is increased by extending life. The equation is an easy, if scary one:
MORE OLD FOLKS = MORE COSTLY MEDICINE
A GovMed option is essential simply because we need a tool to reshape this messed up system. With GovMed in place many sensible things can be done:
1. Offer scholarships in return for physicians entering a national health service.
2. GovMed can be limited to providers willing to accept capitation (pay per patient rather than per procedure). This would limit choice to providers willing to be paid in this way, but private companies would be free to fund those who want to use higher priced docs to do their breast enlargments.
3. GovMed can increase expenditures on development of drugs that save money as opposed to drugs that optimize the bottom line. There are classes of pharmaceuticals NOT being developed today because their is no economic model for their development.
4. Rather than the US subsidizing Canada and Europe, we could develop common research targets as in 3 that would benefit everyone. Imagine European/Chinese/Amwerican drug firms competing to develop the best generics!
The coolest thing about GovMed, as opposed to a single payer system, is that the insurance companies would be free to compete ON PRICE and SERVICES. I suspect many would pay an additional fee for being able, as one example, to have their lung cancer treated by prayer or by the surgeon who looks like Brad Pitt or even to be able to have an elective procedure (eg nose jobs) done sooner. Nothing wrong with capitalism IF there is competition.
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