It is a startling aspect that most other industrialized countries in the world have health care systems that manage to get higher-quality outcomes for a small fraction of what Americans pay … and how much better they have managed the COVID-19 pandemic.
The high-performing countries, like Taiwan’s single-payer system and others, offer important insights. These countries usually begin their debate on health reform by endorsing the ethical principle of social solidarity. The U.S. is different. It has never been able to reach even any semblance of consensus on moral and ethical grounds that health care is a human right and provide federally financed health care insurance for every citizen.
Other countries provide generous benefits for their populations. These countries have no surprising medical bills or price discrimination where hospitals charge vastly different amounts for identical services. Even though there are hospital mergers, they generally expand the market share of acquiring hospitals.
The U.S., on the other hand, is seeing rapid concentration by expansion of hospital services because size provides higher bargaining power with private insurers. This consolidation of hospitals and insurers makes a mockery of the idea that competition can contain prices. The simplicity of Taiwan’s NHI make overhead costs extremely low, i.e., 0.87% vs 13% for U.S. private insurers.
It is reported that many Taiwanese-Americans living in the U.S. keep their Taiwan premiums and go back to Taiwan for medical care. Many other countries have satisfactory health care systems that perform more efficiently than the U.S. Maybe someday our health care system will be transformed from being driven by financial interests, excessive drug prices and private insurers to being a guardian of social justice, equality and human right.