The American Healthcare System is the Least Efficient By Far

During the 2nd presidential debate, Donald Trump accused Hillary Clinton of wanting single payer:

She wants to go to a single-payer plan, which would be a disaster. Somewhat similar to Canada. And if you ever noticed the Canadians–when they need a big operation when something happens, they come into the United States in many cases because their system is so slow, it’s catastrophic in certain ways. But, she wants to go to single payer which means the government basically rules everything.

As a matter of fact this is not Clinton’s position–she has advocated for a public option but not a wholesale replacement of the private sector healthcare system. During the primary she attacked Bernie Sanders’ single payer plan as politically unfeasible:

People who have health emergencies can’t wait for us to have a theoretical debate about some better idea that will never, ever come to pass.

Amusingly, Donald Trump has expressed support for single payer in the past:

The Canadian plan also helps Canadians live longer and healthier than America. … We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.

So today I thought it would be fun to take a closer look at the numbers on healthcare than I’ve done before and look at whether our system is any good at helping people live longer for less money.

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How Single Payer Healthcare Works and What’s Been Going on in Britain

Today I’d like to get at some of the deeper intricacies of single payer healthcare systems by telling you a story about what’s going on with Britain’s National Health Service (NHS). If you’re American, this post will shed some light on how Bernie Sanders’ system potentially works. If you’re British, this is where you’ll get my view on the junior doctors’ strike and what the conservatives are trying to do with the NHS.

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Misconceptions: The United States is Not “Too Big” to be More Like Denmark

Since the Democratic Party debate, folks have been talking about Bernie Sanders‘ desire to make the United States more like Denmark, Norway, and Sweden. One of the most common responses to Sanders I’ve heard is the idea that the United States is too big to successfully imitate the Nordic countries. During the debate, Anderson Cooper himself said:

Denmark is a country that has a population — Denmark is a country that has a population of 5.6 million people.

I’ve seen the same thought echoed by many people, even people who are otherwise quite sympathetic to Sanders. This is very odd, because if we subject this thought to even the tiniest amount of scrutiny, it collapses.

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The Democratic Party Debate: 5 Reasons Why Sanders Won and Clinton Lost

I watched the first Democratic Party debate, hosted by CNN. CNN also hosted the second Republican Party debate, and in both debates it tried to get the candidates to fight each other on camera for the entertainment of the viewing public, repeatedly asking questions designed to get candidates to criticize or attack one another. In the republican debate, this tactic worked perhaps too well–the debate deteriorated into a series of personal attacks, with little relevant policy content. For that reason, I didn’t bother to write up an analysis of the second republican debate–there was little of substance to analyze. The democratic candidates did a better job of resisting their baser instincts, and we did manage to get some interesting exchanges on serious policy issues, particularly between Bernie Sanders and Hillary Clinton. In these exchanges, it was quite clear that Sanders was the winner–his arguments were significantly stronger and more convincing than Clinton’s.

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Martin Shkreli is the Product of a Broken Healthcare System

A lot of people are very angry with Martin Shkreli. Shkreli is CEO of Turing Pharmaceuticals. Turing recently purchased the rights to Daraprim, a drug that treats toxoplasmosis, a condition that poses the greatest threat to people with weakened immune systems, such as AIDS patients. 4,400 people are hospitalized with the condition each year in the US, and about 327 people die on average each year. Once Turing acquired Daraprim, it promptly raised the price from $13.50 per pill to $750. Turing and Shkreli claimed that the price increase was necessary to make a profit and to pay for research and development into new toxoplasmosis drugs, but the medical establishment and the public strongly disagree. Dr. David Relman, chief of infectious diseases at VA Palo Alto Healthcare System, told Fortune:

We are not in dire need of new drugs for toxoplasmosis right now. There is no significant drug resistance problem with toxoplasmosis. We do not need them to be undertaking some self-serving marketing campaign. There is no public health need for such. This is simply about greed.

The HIV Medicine Association and the Infectious Diseases Society of America concurred, writing a joint letter condemning the move. But in going after Shkreli and Turing individually, we’re collectively missing the point–they are a symptom of a much larger prescription drug problem in America.

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