cost per individual per year is lower in other OECD countries because its subsidized through heavy taxation. So, it's not really lower, it's just shifted into a different bucket for accounting purposes. But it didn't go anywhere - that's the point. You can see it easily by the fact that taxation as % of GDP is much higher than in the US. Where does that extra money go? Subsidizing healthcare and other benefits
No. That’s not what I’m talking about. If you think thats what people mean when they say “healthcare is cheaper in countries with single payer” then no wonder you don’t seem to find it attractive.
The cost of providing healthcare (total) is lower in all those countries. That is, a country might use $10k per individual per year for healthcare, financed by taxes. Meanwhile the average for a US individual (paid with insurance) is twice that (those numbers were made up but you get the point).
As you are saying, there is nothing magic about this. Having a single insurance pool and putting the premium on the tax bill doesn’t change much - it’s just accounting. And obviously it will make taxes look higher. But if you pay $1000 per month in taxes and $1000 to healthcare, or $2000 in taxes, it’s just the same thing with a different name.
The difference is this: you could pay $1500 in taxes (with healthcare costing 500 when single payer instead of 1000 via private insurance) And then it’s a very real difference. Again, numbers made up for illustrative purposes. A new US system would likely look like Canadas, so should have similar costs.
No, you don't understand. The actual, economic cost of providing healthcare in those countries isn't lower. It looks lower from accounting point of view because of various hidden subsidies. How do we know this? It's very simple - they have to have a significantly higher overall burden of taxation. Where does that money go ?
In many of those countries the healthcare is completely tax funded. You don’t have to ask people what they pay for healthcare, it’s known from the tax budget.
So these aren’t somehow made up numbers. We know exactly how much money the Swedish government uses to provide healthcare for each Swede.
It’s ALL tax money.
So we can compare that number to what an average American pays for healthcare. And when doing that we have a fair comparison of the cost of healthcare.
Tax burden etc does NOT change this comparison. It’s exactly what this comparison IS. One persons TAXES vs another persons insurance policy + out of pocket expenses for healthcare.
Please don’t reply now with “but taxes are higher so it just looks cheaper!” - if it didn’t sink in now there is nothing more I can do to explain it.
You still don't understand. The total level of benefits and taxation is relevant. Healthcare doesn't exist in isolation. For example, you can pay doctors a lot less because they go to medical school for free and don't have malpractice insurance at the same level and also because their retirement is taken care of by the state. You can pay hospital administrators less and on and on. This lowers the accounting cost of healthcare - but not economic cost. Somebody paid taxes to send that doctor to medical school for free
This high overall taxation enables subsidies which are then used to make it look like healthcare costs, when looked at in isolation, appear lower.
Empirically, we can see this: very few developed ountries are able to provide lower healthcare costs than US while also having a lower overall taxation burden.
Oh. You are thinking of secondary effects of high-tax societies, such as flatter wage structures influencing (production) costs of healthcare. Yes - I absolutely agree that is a factor, and I genuinely believe that if the US wants to see the full economic benefits of single payer they must also make higher education cheaper, reform the malpractice legal frameworks, and so on. The fact that I tax-pay my doctors MD likely makes less of my tax money go to healthcare. Agree.
The UK does have a good single payer system and not (entirely) free higher education, so they naturally have more wage inequality (for other reasons as well including much weaker labor unions and labor laws) and should be a better comparison than e.g Scandinavian countries which has flat wages and tax-funded everything. Canada seems similar (tuition there seems to be around 50% subsidized?)
