I really don’t understand why school and medical care has to be so expensive. In many of our peer countries medical care is substantially cheaper, even outside public services. University, especially on the continent is not something everyone does post their basic schooling. In Germany, as best I understand, a test after 6th grade will determine what sort of schooling trajectory you are on. For example is trade schooling or the university a better track. This makes education much cheaper. Higher education is a no frills public university, technical university (Fachhochscule), trade school etc. Some of these are sponsored by private industry too. There are definitely professions where a degree isn’t necessary or whose entry level is low enough that say a High School Diploma is enough and on the job training (but formal or not) will move the person up the industry career ladder.
(a) The government does not manage prices. Unlike everything else people buy in the free market, when it comes to health care consumers want what seems to be the best and the newest, not the most cost-effective.
Competition and innovation are expensive in other ways. When a hospital first gets a new MRI, it is really expensive but if the next hospital over has one, they need to compete by having the latest equipment. The hospitals have to bill for that equipment in order to pay for it before it is obsolete.
(b) Our complex system makes billing complex, time-consuming and therefore expensive to provide
(c ) Medical school is expensive and self-funded, whereas in places like Germany it is nearly free. The salaries here have to attract the most ambitious and gifted students, because they’re not going to rack up that kind of debt and spend so many years in a competitive school without a lucrative career to pay for it.
(d) Uninsured people are cared for, not left on the streets, so that cost is eventually borne by those who do pay taxes and pay for health insurance.
We also have lower wait times and a more rapid rate of innovation, especially in cancer care. That costs $$$, but people come here from around the world for cancer treatments. Possibly because of our lower wait times, we also have a higher fraction of adults that report being in good health (in spite of our fondness for food and lifestyles that are not conducive to good health).
I think this opinion piece has a lot of good points:
Back to “traditionalists”…there did used to be care for the poor that was provided by religious orders. When health care got to be as complicated as it now is, that model didn’t really work any more. Even religious orders find that sending their members to nursing or medical school or to get a degree in education is a lot more expensive than it once was. That is a function of the same sorts of factors.