My "Maybe We Should Spend More on Health Care" argues that the repeated mantra "we spend too much" is both unsupported and dangerous. We don't know how much we should be spending; that depends on value for money, and the system's incentives are so convoluted that the calculation has become impossible. The risk is that pressure for short-term cost cuts will hobble the innovations -- pharamaceuticals; devices; materials; case managment -- that are needed to improve effectiveness and efficiency.
If the government takes over, all problems will become worse. As one of my old U.S. Bureau of the Budget bosses used to say, "every government program consists of a hard core of fat surrounded by bone and muscle." So the operators and advocates make sure any cuts hurt the public and create a reaction. Waste, fraud, and abuse will continue; it is innovation and progress that will be pinched.
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