High Health Care Costs in the US
High health care costs remain a sensitive political issue in the United States. The recent 43-day government shutdown was partly due to disagreements over expanding health subsidies. President Donald Trump’s approval ratings have also been affected by concerns about the cost of living, including rising health care costs.
The US Health Care System
The US health care system is widely considered the most expensive in the world. According to an OECD report, the US spends by far the highest per capita on health care. The gap between per capita spending by the United States and second-place Switzerland is greater than the gap between Switzerland and Italy in 23rd place.
Causes of High Costs
Experts say that the high cost of health care in the US is due to a combination of factors, including the high prices of insurance and other services that lack transparency and controls over pricing. The system is also highly commercialized, with market mechanisms dominating and individuals being primarily responsible for securing their own health care.
Multiple Systems and Lack of Coverage
The US system is not centralized, with multiple forms of health care and insurance available. However, at least 8% of the population – more than 25 million people – do not have health insurance coverage. The Commonwealth Fund has found that the US has the worst overall health care system among ten high-income countries studied.
Lessons from Europe
Health policy analysts often speculate that the US might learn lessons from countries that outperform it in terms of affordability and health insurance. Germany’s system, which includes mandatory health insurance and broad access to services, offers important lessons, particularly in terms of universal access and solidarity-based financing.
Key to Success
The key to the success of European health care systems is a non-profit ethos and the fact that they must operate under consistent rules. In contrast, the US system is dominated by for-profit corporations that are consolidating and dominating the system in harsh and damaging ways.
Philosophical Differences
There is a profound philosophical difference between how most European governments view health care and how the US government views it. In Europe, health is widely viewed as a social right, while in the US, it is more commonly viewed as a private responsibility. This has a major influence on system design, financing, and public expectations.
