Dr Aaron Carroll of Indiana University studied five other rich-country health systems to figure out what we need in the US:
We are one of the few developed countries that does not have universal coverage. We spend an extraordinary amount on health care, far more than anyone else. And our broad outcomes are middling at best.
When we do pay attention to this issue, our debates are profoundly unproductive. Discussions of reform here in the United States seem to focus on two options: Either we maintain the status quo of what we consider a “private” system, or we move toward a single-payer system like Canada’s.
It’s outrageous that the health care system hasn’t been a significant issue in the 2024 presidential race so far.
Even if we did have that national conversation, I fear we’d be arguing about the wrong things. We have spent the last several decades fighting about health insurance coverage.
No other country I’ve visited has these debates the way we do. Insurance is really just about moving money around. It’s the least important part of the health care system.
Universal coverage matters. What doesn’t is how you provide that coverage, whether it’s a fully socialized National Health Service, modified single-payer schemes, regulated nonprofit insurance or private health savings accounts. All of the countries I visited have some sort of mechanism that provides everyone coverage in an easily explained and uniform way. That allows them to focus on other, more important aspects of health care.
It's almost as if entrenched special interests, like the insurance industry, want us to keep debating insurance rather than health care outcomes. And we seem to fall for it every election.