You’ll find it well worth the time to read. Particularly
interesting to me is Atlas’ statement that “NHS insurance costs $3,500 annually
for every British man, woman and child.”
I looked up the corresponding figure for the U.S. in the
National Health Expenditure Tables published by CMS each year. Doesn't everyone know by now that
the US per-capita annual expenditures are far higher than the UK’s? So that’s not the interesting part.
The interesting part is that the annual US per-capita
health expenditures were $3,500 back about 1994.
But in 1994, that level of expenditure
was accepted in many quarters as conclusive evidence that the US needed single-payer medical care; that the private insurance industry had failed to control medical cost;
and even that the American free market system had failed. And here we are 20 years later
observing the same annual $3,500 per capita . . . as evidence of NHS
success in UK! Meanwhile the much
higher US cost is still accepted in the same quarters as evidence that the US needs single-payer medical care; that the private insurance industry is failing to control medical cost;
and that the American free market system has failed.
I’d like to suggest a slightly different interpretation. I suggest the history shows
that the UK trails the US on cost by about 20 years. In other words, UK's cost reached our 1994 level in 2014; and so UK’s cost may well
reach what ours is today, in 2034. This interpretation also suggests the UK is not retarding the growth of medical cost any
more successfully than the US.
The US is simply the leading indicator for cost growth over time. This interpretation also suggests the higher US point-in-time costs arise from other factors.
I would also note that the UK has for years led the US in terms of restrictions on its citizens’ access to specialized medical
services and newer technologies. In many respects, such restrictions make
sense where overutilization is known to occur; in many other
respects, setting an army of bureaucrats on a mission to "cut medical costs" is
a terrifying idea. But the US now seems committed to a path over the
next 20 years at least, that will produce similar sorts of deterioration in hospital
services, growing wait times, and other restrictions on specialty and high-tech care as
have plagued NHS. In this sense, UK is the leading indicator for the US. Our policy leaders should be paying attention.
Of course, as we learn more about Obamacare, we may find
the US is sinking to the more restrictive UK service levels much faster than anyone imagined - but accompanied by increasing, not reducing, cost. Lower access
to medical care - - higher prices - - Yum!
Posts
