Single payer: better care for less cost?: It's not so easy

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t. As stated, this meme is true enough: America does have higher health-care costs than anywhere else, and we do indeed have shorter life expectancies than some nations. But of course people are not introducing these facts as a fun bit of trivia, like “Babe Ruth used to wear a cabbage leaf under his baseball cap to keep cool.” What they are actually interested in communicating is the implication that America could switch to a single-payer health-care system and thereby enjoy longer life expectancies at lower cost. And that implication is considerably more dubious.

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Start with mortality. A recent survey concluded that “regardless of cross-national differences in access to quality medical care, the fact remains that the overwhelming contributors to the incidence of disease (e.g. poor health behaviors) operate largely outside the influence of medical care.” Americans seem to be sicker than people in other countries, and while people often attribute this to lack of preventive care, on some metrics that ought to improve our life-expectancy -- such as screening tests -- America actually does more than other places. Other contributing conditions, such as obesity, have shown little response to the things that primary care physicians can do, such as tell you that you should lose weight.

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We’re also at greater risk for fatal injuries than people in other countries. We have a higher homicide rate, in part because Americans seem to be more violent and in part because we have greater access to guns. And we drive more, so more of us die in auto accidents. No matter what you think of America’s car-driven development policy, or its gun-control regime, you can’t think that altering our health-care system is going to keep Americans from driving to their suburban homes, or shooting each other.

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Skeptical? Let’s look at what happened when the U.S. greatly expanded the government’s funding of health care: Between 2014 and 2015, age-adjusted mortality rose for the first time in decades.

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hen you actually look at our spending, you see that even before Obamacare, America spent more on its government systems as a percentage of GDP than many of the comparison countries we’re supposed to emulate -- this to cover a fraction of the population. Somehow, getting the government involved did not make American health care cheap.

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No government system in the world has actually lowered health-care costs on any sustained basis, absent something like the Greek financial crisis that forces a sudden and drastic reduction in government spending. Lowering health-care spending means denying treatments, closing hospitals, and cutting provider salaries. Politically, this has proven impossible.

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Looking at our health-care-cost growth for the most recent six years, you see that spending as a percentage of GDP was basically flat from 2009 to 2013, then rose 0.5 percent in the two years after Obamacare kicked in. These numbers are quite comparable to OECD competitor nations, and better than some, such as the UK and Switzerland

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LINK

This author brings up a very interesting point: How do we know that in each european country, it is single payer that is the reason the amount of healthcare spending is lower? Where is the evidence that european nations would have more expensive healthcare if it wasn't for single payer? Virtually all european nations instituted some form of universal healthcare long before we could track any sort of spending data.

We don't have any proof that "country X lowered it's health costs by becoming single payer".

Key question: If european nations are struggling with the US JUST AS MUCH when it comes to controlling RATE of cost GROWTH, what makes people so sure that single payer here would not just lower the rate of growth, but make the growth negative?