WAPO article for you to read today: explains why we can’t cut health costs to Euro levels

LINK

First part of article is simply a rehash of the fact that you cannot fund welfare state off of solely the rich.

Here is the part that I find nicely explained:

quote:

---

This, however, is not even the biggest factor obstructing left-wing dreams. The real thing standing between them and their proposed Scandinavian paradise is Father Time.

Let’s return to national health care. It’s practically a mantra on the left that every other country in the developed world has a marvelous system that provides better outcomes at lower costs, so why would we want to stick with the obviously subpar American model?

n fact, it’s debatable whether the other countries’ systems get better outcomes: Once you’ve controlled for factors that have almost nothing to do with the health-care system, such as homicides and car accidents, it’s not clear people in other countries live any longer. But it is not debatable that they are cheaper; we are the only country in the world that spends a fifth of our gross domestic product on health care.

And why do we spend so much? Because everything is organized to make the system costly, from the cost of labor to the number of machines we use to the way we construct our hospitals. (Yes, we pay a lot for drugs, but drug spending is only a small fraction of total spending, so this cannot account for the difference — and neither, before you ask, can insurer profits or administrative costs).

It is possible that we could have controlled these costs, once, as other countries have done. But as any legislator, or parent, will tell you, it is a lot easier to not do something than to stop doing it. Some things we’ve done can’t be undone at all — our hospitals are now constructed around private- or semi-private rooms with intensive electronic monitoring of patient status, and we can’t convert them to space-saving, labor-economizing open wards without spending more than the project would save us.

---

quote:

---

Other cost-saving measures are theoretically feasible but politically catastrophic. American health-care workers are very highly paid compared with their international counterparts, and we have a lot of them, all very well politically organized. Those people have planned their lives around their steady jobs and strong earnings — mortgages, car payments, college tuitions. Suddenly announce that you’re slashing everyone’s salary by a third to make national health care affordable, and you’ll have a modern-day Bonus Army marching on Washington, scalpels in hand.

---

The main idea right here:

quote:

---

This is why no nation in the world has managed to make sustainable cuts to their health-care system. They have kept costs from growing, yes, but except in the case of fiscal crises such as the Greek debt disaster, no country has actually slashed what they were already spending. If others can’t, then it’s probable we can’t either — at least, short of a Soviet-style revolution, which is a cure worse than the disease.

What we’re talking about is a phenomenon known as “path dependence”: What you can do now depends on what you’ve already done.

---

Path dependency is going to be a huge concept if bernie sanders gets in there and pushes for european levels of health spending.

Does he advocate tearing down American hospitals and rebuilding them the way european hospitals are built?

It would be inane to carry out such an endeavor.

That is an example of path dependency. The options we have today are determined by decisions we made long ago. We chose to build hospitals based on private rooms and labor intensiveness that europe did not build.