(03-06-2020 01:53 PM)b0ndsj0ns Wrote: Well I guess the question would be what are the mechanisms that allow the countries that have forms of government run health care to keep costs down that don't exist in the ACA? Yes we can obviously point to differences in size and demographics and everything else between the US and every other industrialized country but what is every other country able to do that the ACA isn't?
https://www.pgpf.org/blog/2019/07/how-do...-countries
Four things:
1) They pay providers less for providing the same service. Over time, people figure out that medicine is not quite the financially attractive career path that it once was, and after a couple of generations, your brightest and best no longer go into medicine. You make up for it by importing docs from third world countries, who may or may not have the level of training and expertise that you would like.
2) They force drug companies to sell pills for the marginal price to manufacture, with no absorption of R&D costs. Those costs fall almost exclusively on US consumers. The way to lower US drug costs is to force foreign countries to pay their fair share.
3) Once you turn 65 or so, they pretty much cut off health care, particularly anything that might be expensive. The difference between US health care costs and other countries is almost entirely attributable to costs incurred in the last 3 years of life. There's a reason.
4) Their legal systems are different, and one consequence is that they don't get the same jackpot malpractice judgements that we do here. Sweden has no-fault malpractice that basically works the way workers' comp does here. That cuts the cost of malpractice insurance dramatically.
If you want to cut the price of medical services, you have to cut the cost to provide. Otherwise you just eliminate profit, and nobody wants to do it any more. Cutting malpractice insurance helps. Making foreign countries pay their fair share for drugs reduces the cost to US consumers. Another thing that we could do if we did Bismarck is something like what the military does, have a "free" side and a "pay" side, and if you agree to work for a salary on the "free" side for 10 years, we pay your way trough med school. So you get your M.D. basically free, you work for a fixed salary on the "free" side for 10 years, you develop your specialty and your expertise, and then you move to the pay side and make money.