In a recent editorial, David Brooks asks whether market incentives work in health care. A more meaningful question may be whether any so-called market-based system can outperform publicly financed systems that provide universal coverage for all citizens. The evidence suggests that the answer is probably “no.”
The health care system we had before the Affordable Care Act was more expensive and produced worse outcomes (shorter life expectancy, more chronic conditions) than the publicly financed universal systems in practically all other developed countries in the world. We spent 17 percent of our gross domestic product on health care in 2015, 67 percent more than the average for Organization for Economic Cooperation Development countries and about 50 percent more than the next highest country (Switzerland — 11.5 percent). While the ACA extended coverage to many people who did not have it before, it did not do very much to improve the basic inefficiency of the system.
If the Republicans are ready to move beyond political gamesmanship and replace “Obamacare” with something better, that would not be hard to do. It’s called single payer.
Chris Toews, Atascadero
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