Okay, it’s been a few weeks now but I made a couple of assertations above which, if true, I believe deeply change the healthcare debate.  I’m hoping somebody can verify or refute them.  I’m NOT accusing Deus of ignoring the issue because he hasn’t even logged in since shortly after I made those statements.  I’m hoping he comes back and finishes the conversation, but he’s not the only one qualfied around here.

My assertations, followed by a little clarification, are:

1) In the U.S., at least, the publicly funded portion of our healthcare is actually more expensive than the privately funded portion.

This is usually contradicted in articles displaying public vs. private healthcare costs in terms of $/capita.  However, if those costs are determined by dividing each total expenditure by the total number of people in the U.S., or even the total number seeking care, then the comparison only has value if the public and private systems treat the same number of people.  But they don’t.  One of the articles I cited above pretty much works out that the public system covers half as many people as the private system, but that the public system costs 45% of total expeditures compared to 55% (duh) for the private system.  If the $/capita figures are based on dividing each cost by the same number of people, the private system appears more expensive BECAUSE IT COVERS MORE PEOPLE!!!

If I’m right, then a major portion of the healthcare debate in the U.S. is almost completely turned around.  One of the main complaints is that healthcare costs too much, and that therefore the government must intervene to lower costs.  This doesn’t directly address the problem of the uninsured, but if we switch to government coverage and it turns out to be MORE expensive per person, then we go from an uncomfortable situation to an intolerable one.

2) Even more controversially, I claimed that healthcare in France isn’t actually socialized.  It’s government-regulated but market driven, much like ours.

From the readings I found, France has both public and private providers (like the U.S.), private insurers that are both for-profit and non-profit (like the U.S.), and a safety net for low-income households (like the U.S.).  Now, France could have a larger share of public providers, and maybe a bigger safety net, but if so these are differences in degree not form.  Where France really differs from the U.S. is that in France health insurance is compulsory.  Employers are required by national law to provide health insurance to employees.  From the French immigrant that I spoke with in jury duty last month, employers basically itemize health insurance as part of salary.  “Your salary is $80,000, but we’re holding $10,000 back to buy you health insurance.").  Such a requirement might actually increase unemployment, but the degree of increase and the value of that tradeoff are perfect subjects for debate.

Now, if I’m right about that, it changes the international healthcare debate.  Deus claimed that the best socialized system was better than the best private systems.  But I don’t see the argument being for a completely unregulated private system, so I interpret Dues’ claim to be that the best socialized system is better than the best non-socialized system.  But if France’s healthcare is #1, and it isn’t socialized, then clearly we have a different debate here.