So, from a health economics point of view.

  1. It is incorrect to say that a government system will be more expensive. Theoretically you may find it difficult to believe, but the vast majority of OECD countries do it. France, England, Australia, The Netherlands, they all have largely government health systems and pay less than half the cost of healthcare that the US does.
  2. Preventative care is almost always many times less expensive than more advanced care. Take HIV. The lifetime cost of HIV is about $400,000 to the health system, whilst the cost of preventing a case is about $40,000. That includes all of the people who are given preventative treatments who wouldn’t have needed it anyway. So providing basic preventative measures for HIV (i.e. needle exchange programs) saves the economy literally billions per year, but is something that needs to be offered at a system level because generally hospitals can’t manage to do this on their own.
  3. Non-US countries have significantly better outcomes in terms of wait times, complication rates, and health generally. As a very general rule, the US has some of the best figures for its top hospitals, but if you look at the population figures, you’ll see that it does very poorly. This is because of the imbalance in healthcare provision (lots of people have bad/no insurance). The NHS is one of the best healthcare systems in the world, and like France (who had the worldwide best healthcare in 2016) it is a socialized health system. The UK regularly thrashes the US in most comparisons of healthcare systems.
  4. Your statements towards the end are all simply wrong. Governments do sometimes ration care, but no more than in the US, simply for different reasons (i.e. rationing based on supply rather than income). Drug treatment options are rarely limited; the difference is that you can only buy drugs which have a solid evidence-base. The US is notorious for approving drugs on the flimsiest evidence due to loopholes in regulation that then stay on the market for years despite them being totally ineffective. This costs the healthcare system untold billions. A government system also sets drug prices, which is the main reason that the US pays more than double the OECD average for drugs; in Australia (for example), the government regulates what pharma companies can charge, and so drugs are far cheaper.

I could go on, but this is becoming an essay. Suffice to say that the model suggested in the article (whilst absolutely not exhaustive) would probably result in lower healthcare costs in the US.

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