Now, the fact that the French spend about half what we do doesn’t mean that we’d cut our costs in half if we adopted a French-style system. We wouldn’t. There’s too much path dependence and too many cultural differences for that. But what it does mean is that if we adopted something close to their system, we could certainly achieve high-quality 100% basic coverage — with the ability to purchase extra coverage for anyone who wants it — for no more than we spend now and possibly a bit less.
We won’t, of course, because too many people are still convinced that healthcare in the United States is better than it is in France — or anywhere else. It’s not. It’s worse and more expensive. Somebody tell Max Baucus.
Afterward, Sen. Ken Salazar, D-Colo., who has since become interior secretary, noted that other countries saw a conflict between profits and health. How could the United States possibly persuade insurance companies to give up profits? [Author T.R.] Reid answered that Switzerland, home to many powerful insurance companies, had done it in 1994 when it adopted the Bismarck model. The insurers fought it tooth and nail, of course, but now they compete energetically to sign up people for basic care on a nonprofit basis because they constitute a customer base for supplemental insurance that they’re allowed to sell on a for-profit basis. This answer didn’t satisfy Baucus. “Perhaps you don’t know how much money [U.S. insurers] have,” he told Reid.
As I’ve said before, it’s as if Baucus doesn’t realize that he’s the single most important person in Congress on this issue. He could just decide not to listen to the insurers no matter how much money they have. Instead we get things like Rahm Emannuel floating compromises about introducing a public insurance option only after a “trigger” test has been passed. This really only makes sense if you think protecting the profits of insurance firms is an independently desirable policy goal. You’re open to the possibility of a public plan, but you want to err on the side of avoiding its introduction because . . . well . . . because . . . it’s not really clear.