Controlling the Costs of a Single-Payer Heatlhcare System
April 6, 2012 8:04 AM Subscribe
How would Congress control costs in a single-payer healthcare system?
posted by toomuchpete to law & government (26 answers total) 7 users marked this as a favorite
In the midst of some fairly in-depth discussions about the ACA, the individual mandate, and possible alternatives, I ran into an issue I couldn't really navigate around without a lot of hand-waving, so I'm hoping the hivemind has some links or info that might help.
First, take as a given that if universal, single-payer health-care were implemented in the United States it would have the effect of having some cost-lowering effects on account of: more preventative care, less cost shifting, and a generally more well-cared-for populace. I know there are some debates about this, but I'm not worried about those at the moment.
Instead my question is how congress keeps prices down with respect to what the prices "should" be.
To elaborate: once single-payer is implemented, health care costs the government whatever it costs, but it seems that, over time, a system this large is going to produce waste, corruption, and generally be subject to the kinds of things federal programs have long been ridiculed for.
Let's also assume, for the sake of argument, that congress has a strong motive to control costs (maybe there's a balanced budget amendment?) and doesn't have a huge pharma / medicine lobby pushing them to spend more and more on healthcare all the time, even if they can't afford it.
So what's out there? How do other single-payer countries keep the costs down? Would those methods be applicable in a system as large as the United States'? What mechanisms and organizational structures might the federal government use to police their rates? What roles do the States have in all of this?
Is there any indication that congress could actually be trusted to keep the costs down? Say, examples of programs where they've done comparably to private industry in terms of cost containment?
A natural segue, but one I'm not really thinking about right now: whether or not congress' inability to control costs would make it worse / more expensive / etc. than what we have now or worse / more expensive than some other non-single-payer system.
Those are all tangents I will eventually explore, but for now I'm really interested in this one question, which essentially boils down to: is congress even capable of establishing a system that could control health care costs while providing a reasonable level of care?