I understand why people use this talking point. It's easy to say and the reasons why it's nonsense involve details.
You can't compare life expectancy without accounting for cultural or geographic differences. The US has a higher rate of motor vehicle fatalities (as a result of driving more), more suicides and drug overdoses etc. These bring down life expectancy because they disproportionately impact the young. The US also has a lower population density which worsens emergency response times.
But one of the biggest factors is that the US system is really terrible for people without insurance. The outcomes for US patients with health insurance are better than they are just about anywhere. Lack of insurance is an economic problem, solvable by instituting a UBI or similar so that the people who can't currently afford insurance become able to.
One of the reasons why the US system is more expensive was already described above -- paying market prices when other countries use price controls has the US subsidizing medical R&D for the rest of the world.
There are also several other reasons costs are high specifically in the US. For example, there aren't enough residency slots but residency is required by law, which limits the supply of doctors. The FDA requires extremely expensive clinical trials but doesn't pay for them, which makes it nearly impossible to bring a new medicine to market that isn't under patent. There is a major lack of price transparency which prevents patients paying out of pocket or with high deductible insurance from comparing prices for non-emergency procedures. These are regulatory failures, not market failures.
> The outcomes for US patients with health insurance are better than they are just about anywhere
How many people in the US lose their health insurance because of serious health issues e.g. lose their job, or run out of money for private insurance due to spiraling costs of dealing with a serious health problem? Or because they are old? Or because due to a slight health issue, confounding effects make it much less likely to have insurance? Or poor people have worse health and they can’t afford insurance?
Saying outcomes are better for those with insurance could very easily be due to other correlated causes, and not due to the healthcare system working well.
So cultural differences like substance abuse and suicide between the US and Europe explain nothing there, but cultural differences between people with and without health insurance in the US explain everything?
You're basically making the opposite point. Maybe people also live longer in Europe because they have more of a safety net (and therefore less severe poverty) in general, and so what the US really needs is a UBI rather than single payer.
That's amazing how you seem to live in an happy imaginary world where everything is fine. There's not much to discuss when you're just making pretty stories to convince yourself. Good day.
Do you actually have a counterpoint? OP's argument is well-reasoned, is shared by others [1][2], and is also empirically supported by actual market events[3][4][5].
Of course it's shared by others! The “free market is the solution, stupid” political stance, is one of the most common tropes of the [American] conservatives.
The fact that American life expectancy is due to “cultural differences” is unsubstantiated, the fact that with health insurance, the US health care system is the best of the world, is also bullshit. Same for “the US subsidizes health R&D for the rest of the world” (this is true for “neglected diseases” though, but because of philanthropists, not because of the domestic healthcare system). And I'm not even talking about the fact that “lack of insurance could be solved by UBI”!
It also fails to realize that “competition” itself often adds more costs than the efficiency benefits it provides, because of fixed costs (each private insurance company share the same set of administrative costs), because customer acquisition leads to big marketing spending, and because competition can drive salary costs up for jobs with limited supply (physicians here), because the competition is also at play when hiring.
But the free market enthusiasts don't really care about facts, free market is a religion and all I said is blasphemy.
> Such patients live, on average, 10 years longer in Canada than in the United States. Among U.S. patients, those without known coverage have the shortest survival; among privately insured persons, life expectancy is similar to that of patients in Canada
You can't compare life expectancy without accounting for cultural or geographic differences. The US has a higher rate of motor vehicle fatalities (as a result of driving more), more suicides and drug overdoses etc. These bring down life expectancy because they disproportionately impact the young. The US also has a lower population density which worsens emergency response times.
But one of the biggest factors is that the US system is really terrible for people without insurance. The outcomes for US patients with health insurance are better than they are just about anywhere. Lack of insurance is an economic problem, solvable by instituting a UBI or similar so that the people who can't currently afford insurance become able to.
One of the reasons why the US system is more expensive was already described above -- paying market prices when other countries use price controls has the US subsidizing medical R&D for the rest of the world.
There are also several other reasons costs are high specifically in the US. For example, there aren't enough residency slots but residency is required by law, which limits the supply of doctors. The FDA requires extremely expensive clinical trials but doesn't pay for them, which makes it nearly impossible to bring a new medicine to market that isn't under patent. There is a major lack of price transparency which prevents patients paying out of pocket or with high deductible insurance from comparing prices for non-emergency procedures. These are regulatory failures, not market failures.