Paul Krugman on why Medicare is comparatively more expensive than single-payer health programs in other nations:
What is true is that the U.S. Medicare is expensive compared with, say, Canadian Medicare (yes, that’s what they call their system) or the French health care system (which is complicated, but largely single-payer in its essentials); that’s because Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.
So Medicare will have to start saying no; it will have to provide incentives to move away from fee for service, and so on and so forth. But such changes would not mean a fundamental change in the way Medicare works.
It’s worth pointing out that the lawmakers who oppose the cost-containment measures Krugman describes are more inclined to fear monger and complain about Medicare’s “unsustainability” and increasing costs. So next time you see Republicans arguing that Medicare is going broke and won’t be there for future generations of Americans, recall that they all voted against, demagogued and proposed amendments to significantly limit the application of comparative effectiveness research in Medicare — so that the program is not paying “for medically dubious procedures” — during the health care reform debate and are now leading the charge to repeal the ACA’s Independent Payment Advisory Board (IPAB).