A health care idea: Start from scratch, look to other nations

That sound you hear is disbelieving California taxpayers howling in outrage. The state has hundreds of billions of dollars in unfunded liabilities and in unfunded infrastructure needs and among the nation’s highest taxes. Even so, a state Senate committee has already given its blessing to a bill creating a state single-player health care system that could double the size of the state budget — or worse.

But the measure co-authored by state Sens. Toni Atkins, D-San Diego, and Ricardo Lara, D-Bell Gardens, does have an upside: It may prompt people to consider the idea that when it comes to health care, Americans need dramatic change. We should pass on the clunky, costly approach of the Affordable Care Act and the cruel replacement passed Thursday by House Republicans that would deny ready access to health care to millions of people.

Instead, we need a national debate. It shouldn’t start with ideological frays over whether giving the government an even bigger, more direct role in health care amounts to socialism. It needs to start with the fact that the U.S. model of health care costs far more and doesn’t deliver as good results as the models used by other nations. It’s broke. Let’s fix it.

A 2015 Commonwealth Fund study of 13 high-income nations found the United States spent roughly between 50 percent and 100 percent more of its gross domestic product on health care than any of the 12 other nations while having the lowest life expectancy and among the worst health outcomes, with the significant exception of treating cancer. U.S. costs are sky-high even though Americans are less likely to visit doctors or go to the emergency room than most nations.

Why are U.S. costs so high when health-care use is less common? The Commonwealth Fund study is one of many that has pointed to the heavy use of expensive medical technologies such as MRIs; the high cost of prescription drugs; and the far higher cost of medical procedures. It also notes the lack of efforts to base provider pay on patient outcomes.

So that’s why the U.S. system is so costly. But how did America get to this place? Because, as Derek Thompson wrote in The Atlantic, while “some developed countries have one health care insurance plan for everybody — where the government either sets prices or oversees price negotiations — the U.S. is unique in our reliance on for-profit insurance companies to pay for both essential and elective care.” These companies operate in a health arena in which there are dozens of government health care systems and hundreds of private systems — creating vast redundancies and huge administrative costs.

Instead of squabbling over rival versions of a flawed system, Americans would be far better served if our leaders started from scratch and copied what worked better elsewhere. This viewpoint may seem novel. It’s really just common sense.

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