You know, I’m as much pro-public healthcare as you can get (like 99.9% of people living in a country with such a system) and I mentioned many times that I held the system used in my country in high esteem.
However, I’m not sold on the idea that a reform of the US system will result in lower costs. Basically, there are a lot of issues that won’t be solved by just reforming the system. For instance :
-As long as insurance is delivered by private for profit insurers, this profit won’t go away.
-As long as there’s a gazillion different plans with a variety of items covered or not, the massive overheads both on the side of the insurers and on the side of the providers won’t go away (for reference, all my doctor has to do is enter a code for whatever he did and sweep my HC card. That’s all the insurance-related paperwork that has to be done. Imagine how many billions are wasted when the insurer and the doctor’s office has to handle it on a case by case basis. Not even counting the patient’s time. That might be the single biggest issue in the USA)
-As long as there’s a “sue anyone I can think of for any reason” mentality, malpractice insurance costs won’t go down.
-As long as doctors have to pay for their education and reimburse huge loans, you won’t convince them to lower their prices.
-As long as, in the name of free market, there’s no will to negotiate with the pharmaceutical industry (to cover, amongst other useless things, adds for the general public, whose job is certainly not to figure out what drug they need by watching TV) drug costs won’t go down.
-As long as the majority of large hospitals are private, you won’t get any efficient attribution of the nice toys every single hospital wants to have, and as a result an overuse of those just in order to amortize the huge costs (or cover the hospital’s ass, see above about lawsuits)
-As long as each provider is free to charge, for the same procedure, widely different prices for different patients (insured or not, an issue frequently discussed here) nobody will have a clue what the real costs are and where the money really goes.
I probably forgot some items, but you see the picture. Since there won’t be a massive overhaul of the whole American system, whatever you’re going to come up with certainly won’t reduce healthcare costs to European levels. I suspect that those costs, in fact will rise. “Obamacare” is a good example of that. It’s a good thing because it will prevent some of the horror stories we read about here on a regular basis (sometimes involving dopers) . It might, over time, reduce some costs as a result of a better access to preventive care or early care. But this won’t happen immediately, and will be difficult to notice it, let alone put a price tag on it.
So, call me a skeptic. I fully agree that the American healthcare system is a general nightmare and absurdly costly, but I don’t see any improvements cost-wise until the next revolution. European systems have been created long ago, either on a pre-existing basis (insurance provided and managed, not bought, by large companies, industry branches and/or unions like in Germany or France) or essentially out of thin air (like in the UK) but none had at the time to deal with an existing, dinosaur-sized, health care system with a lot of big players who have a vested interest in not reforming it.
Good luck.
