Mt. Vernon Register-News

Opinion

May 1, 2014

Single-payer system won't save U.S. health care

(Continued)

Here’s the problem with that idea:

We are not a nation that has a cost-growth problem; we’re a nation that used to have a cost-growth problem, in the 1970s and 1980s:

That is why we cannot count on financing single-payer with the fabulous cost savings to be gained by making our system more like Europe’s. Europe didn’t gain fabulous cost savings by making their systems more like Europe’s: Its nations started from a lower base, and held down cost growth, but they did not actually use single-payer systems to cut what they were spending.

Once spending is in the system, it’s hard to get rid of. I’ve already covered the political difficulties with using government power to take income away. But those aren’t the only problems. For example, in the middle of the last century, the U.S. decided that private or at most two-person rooms were best, because they made it easier to control infection and to let patients rest. For decades, we built hospitals to this standard; when my mother was in the hospital for a complicated appendectomy, there weren’t even any semi-private rooms on the surgical ward.

Private rooms drive up costs in a lot of ways: They take up more space, you have to duplicate equipment, and because the nurses can’t see the patients, you need more monitors and/or staff circulating to make sure no one has stopped breathing. Basic hospital rooms in many other countries look spartan and overcrowded compared with what most Americans are used to, because they have more people and fewer beeping machines.

But even if we got a single-payer system tomorrow, we would not be able to do what those other countries have done, which is not build expensive single hospital rooms in the first place. Those hospitals were built over time, as funds became available and as the old buildings wore out. Trying to replace them all at once with semi-private rooms or wards would cost more than just sucking up the extra expense of the hospitals we have.

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