Krugman on Health Care

Curse the New York Times for their subscription wall on the web, without it I would provide a link. Paul Krugman today provides us a new installment in his excellent series of articles advocating universal health care coverage.

Let's start with the fact that America's health care system spends more, for worse results, than any other advanced country.

In 2002 the United States spent $5,267 per person on health care. Canada spent $2,931; Germany spent only $2,160. Yet the United States has lower life expectancy and higher infant mortality than any of these countries.

But don't people in other countries sometimes find it hard to get medical treatment? Yes, sometimes- but so do Americans. No, Virginia, many Americans can't count on ready access to high-quality medical care.

The journal Health Affairs recently published the results of a survey of the medical experience of "sicker adults" in six countries, including Canada, Britain, Germany, and the United States. The responses don't support claims about superior service from the U.S. system. It's true that Americans generally have shorter waits for elective surgery than Canadians or Britons, although German waits are even shorter. But Americans do worse by some other important measures: we find it harder than citizens of other advanced countries to see a doctor when we need one, and our system is more, not less, rife with medical errors.

Above all, Americans are far more likely than others to forgo treatment because they can't afford it. Forty percent of the Americans surveyed failed to fill a prescription because of cost. A third were deterred by cost from seeing a doctor when sick or from getting recommended tests of follow-up.

...

Taiwan, which moved 10 years ago from a U.S.-style system to a Canadian-style single payer system, offers advantages of universal coverage. In 1995 less than 60 percent of Taiwan's residents had health insurance; by 2001 the number was 97 percent. Yet according to a careful study published in Health Affairs two years ago, this huge expansion in coverage came virtually free: it led to little if any increase in overall health care spending beyond normal growth due to rising population and incomes.

Emphasis mine. Not only would universal coverage by good for the general public at large, but it would be good for business as well. Businesses would no longer feel any obligation to provide health care to their employees if everyone had health care guaranteed as a United States citizen. This would mean that employers would be able to pay more to their employees in wages and other benefits while actually spending less. This is a good deal for everyone except the insurance industry, but unfortunately it is the insurance industry who seems to have a death grip on Congress.