John McCain Once Again Demonstrates Total Ignorance of Vital Public Policy Debates

One of the frustrating elements of the health care debate in the United States is that not only are the legislative options constrained by the dread “political reality” but the actual conversation around the issue is weirdly hemmed-in by America’s ideological hang-ups. There is, for example, simply no way to dispute the fact that other developed countries with national health care systems also have more efficient health care systems. There’s maybe a credible argument to be made that the United States couldn’t realize those efficiencies, but no serious person can maintain that they don’t exist. And yet here’s John McCain saying “the idea that somehow the government can administer health care in a more efficient fashion than the private sector I think flies in the face of examples of other countries that have done so.”

He went unchallenged on this assertion because in America “everyone knows” that government is inefficient and “everyone knows” that foreign countries are bad. But as Ali Frick points out “McCain is simply wrong” and the American health care system is hideously inefficient:

Compared with five other nations — Australia, Canada, Germany, New Zealand, the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives.


Efficiency: On indicators of efficiency, the U.S. ranks last among the six countries, with the U.K. and New Zealand ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of the use of information technology and multidisciplinary teams. Also, of sicker respondents who visited the emergency room, those in Germany and New Zealand are less likely to have done so for a condition that could have been treated by a regular doctor, had one been available.

To understand the point about efficiency you have to understand how much more the United States spends than other developed countries. Per capita health spending in Switzerland is 68 percent of what we spend. And that’s the most expensive country! In Canada it’s 57 percent In Denmark it’s 51 percent. In the UK it’s 41 percent. In Finland it’s 38 percent. The OECD median is 44 percent. Under the circumstances, the claim that our system is more efficient is an extremely bold conjecture. The idea would have to be that not only is our health care in some sense “better” than Danish health care, but that it’s actually twice as good in some sense even though Danes don’t seem to be healthier along any metric.