The most recent issue of Time magazine features an article by Steven Brill which deals with the question of why health care costs are so much higher in the U.S. than they are in other countries. Brill shows that it basically comes down to greed: hospitals charge high fees simply because they can get away with it. The logic of the “free market” doesn’t apply to health care. If, for example, you’re in a car accident and your leg gets crushed, you don’t have a choice of whether or not to get medical attention. And you don’t have the luxury of being able to shop around for which emergency room has the lowest prices. (This is an argument that we on the Left have been making for decades. It is satisfying to see a mainstream media outlet finally admit that we are right.)
Brill describes how “non-profit” hospitals rake in enormous profits, so much so that their top administrators can receive multi-million dollar salaries. Medicare, Medicaid, and private insurers use their influence to try to keep costs down, but their efforts don’t apply to the millions of Americans who don’t have coverage. What we’re seeing is a sophisticated form of bottom-feeding: hospitals are gouging the most vulnerable members of our society. Brill is also critical of the pharmaceutical industry. He demolishes their claims that research and development justify the high prices they charge.
Brill gives a spirited defense of Medicare. He shows that it is actually run in an efficient manner. (Hospitals are reimbursed more quickly by Medicare than they are by private insurers.) He is, on the other hand, critical of Obamacare. Among other things, he points out that it will likely lead to higher insurance premiums.
Brill suggests expanding Medicare so that it applies to everyone. This strikes me as the most rational solution to our health care problems.
This article on Obamacare by Doug Henwood is also worth reading.