Why America 'cares' less about cost control than other countries
Tyler Cowen wonders why other countries care more about cost control in health care. The answer, in part, is that health care is on the budget in other countries, while that's not nearly as true here. That, arguably, leaves you in the same place: If Americans cared as much about cost control, they would put the health-care system on the budget, or they would tighten their grip around Medicare and Medicaid, which are counted in federal budgeting.
But the broader answer probably has fairly little to do with public opinion and quite a bit to do with political structure. If Truman or FDR or Nixon or Clinton had passed the health-care reform proposals they envisioned, health care would be on the budget and cost control would be a lot tighter and we wouldn't be asking this question.
But our system makes it very hard to get anything done, and so none of them managed that feat. You can chalk that up to American "values," but since Americans also elected all those presidents, it's not a particularly compelling argument. The difference between American and England is that in England, one of those leaders would have passed health-care reform and systematic cost controls would have been imposed decades ago, while in America, none of them managed to do so, and so spending just followed its natural path.
October 30, 2009; 5:06 PM ET
Categories: Health of Nations
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