I’ve only shown a few countries, to keep the graph easy to read, but these examples aren’t cherry picked, except that they’re big rich countries like us. When you dig into the Organization for Economic Cooperation and Development data, you don’t see any government, anywhere, making sustained cutbacks in the health-care system, except for situations such as in Greece, which cut back substantially in the middle of an economic meltdown and a sustained run on its government debt. Absent the impetus that a whopping financial crisis provides, at best, you see them hold down cost growth.
Holding down growth rates is feasible — give people a smaller bump in what they were expecting. Cutting spending is absurdly difficult, because it means cutting people’s incomes. Incomes that they counted on to help make their mortgages and car payments. Maybe you don’t feel so bad for expensive surgeons who have to sell the Bimmer, and I don’t, either. But America’s cost inflation is not just fancy surgeons. It’s everything: surgeons, general practitioners, nurses, respiratory technicians, private hospital rooms, MRIs, CT scanners — and I haven’t even gotten to drug prices:
Here’s the advanced electoral math:
We might be able to hold down future costs, but there is no evidence that we can cut the costs we already have back down to the level of those European nations that single-payer advocates like to cite. In fact, I’d say there’s quite a bit of evidence to the contrary.
Well, that’s something, isn’t it? Let’s get a government system in there, get our cost growth down to the level of other OECD countries instead of the insane rates that our inefficient private system produces. Eventually, as the economy grows, health care will shrink relatively, if not absolutely, and the proportion of national income that Americans spend on health care will come to resemble that of the rest of the world.