Our broken health-care system

Robert Samuelson

The Washington Post

If our nation is serious about taming runaway deficits, said Robert Samuelson, we have to cut the cost of health care. Our health-care system is by far the most expensive on the planet—50 percent more costly per person than Norway’s, the next costliest. Yet our life expectancy (78.2 years) is just 27th in the world, behind Chile’s, and we get fewer doctor visits than in most other developed countries. So why is health-care spending now devouring 27 percent of the federal budget, and rising? The “fee for services” system here encourages doctors to run up the bill. “The more they do, the more they earn.” And doctors and hospitals here charge steep prices: A coronary angioplasty costs $14,378 in the U.S., and just $7,027 in France.

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To stop this ruinous escalation, tinkering won’t do. We must choose between two radical overhauls: a voucher system like that proposed by Rep. Paul Ryan, which would privatize Medicare and let seniors shop for the most cost-effective health plan; or a single-payer system like Britain’s, with spending limits on doctors and hospitals—and yes, rationing. “If we don’t act, we’re surrendering our future to runaway health spending.”