1. And you were incorrect. Government processing costs are not higher in most OECD countries with socialized health systems. Whilst there is a theoretical argument that they *should* be, in fact more regulation often results in lower processing costs, for a number of reasons.
  2. Mammograms (and prostate exams) are actually extremely cost-saving in certain populations. The debate largely centres around where they become a waste of time/money; for example, screening all 30-year-old women for breast cancer is not useful, because the risks are too low to justify the cost. However, overall, spending on preventative healthcare brings a significant savings to the health system overall. When you say ‘preventative care’ you seem to be referring to over-testing which is a problem in the US, however this is not what is traditionally called preventative care. Over-testing is also something that government regulation can address; in Australia, the government funds a certain number of tests per year, with further expense coming out of your own pocket. In effect this means that people are only tested the medically recommended number of times, and medical services cannot over-service their patients (the reasons behind over-servicing are complex, but regulation is one proven method of reducing it).
  3. The US has amongst the best cancer survival rates (this is NOT true for heart attacks), but Canada actually does better, and Australia doesn’t lag far behind. For many hundreds of conditions the US is worse. Keeping the cancer survivability rates high is a laudable goal, but given that the US is so unbelievably far behind most other OECD countries on, say, mental health, it’s perhaps not the most vital part of the health system to address. You are right in that doctors in the US generally earn more. Other health professionals, not so much. And the amount they earn more is not nearly as large as you imply; it’s more like 20–30% on average. As well as that, in Australia most doctors have a private practice as well as a public appointment, meaning that your idea of “serfs of the state” is simply ludicrous. Funnily enough, many OECD countries currently have an OVERsupply of doctors. You know which country has a massive shortage? The US. So it appears that socialized medicine is actually an encouragement to pursue a medical career, perhaps because the salary is compensated for by better working conditions and a more flexible life. And we can look at what happens when drug companies are regulated more effectively all over the world; innovation isn’t stifled, pharma keeps making money, and yet drug costs plummet. You ask the question as if the rest of the world hasn’t figured out a good answer, but most other countries have just as excellent drug innovations with massively lower costs.
  4. I do believe that, because of what I said above. The US is unique in its amazingly lax regulation; other countries can both regulate and innovate. The UK, for example, pays about 1/3 for their drugs and also has a massive pharma industry. Germany, The Netherlands and others are similar. This is partly because much of the development and testing of drugs is done overseas in developing countries, where the costs to run a trial are minimal. But this is true of the US also; the main difference in expenditure for US drug companies isn’t R&D, it’s marketing. US companies spend only ~20% of their budget on drug development compared with ~60% on marketing.

Epidemiologist. Writer. Podcaster. Twitter https://twitter.com/GidMK FB www.facebook.com/gidmkhealthnerd/ Email gidmk.healthnerd@gmail.com