The path dependence of health care institutions

Let's say you favor one of the health care plans currently under consideration.  Should you believe it would have been easier to switch to your favored plan in, say, 1972 rather than today?  I suspect the answer is yes or maybe even "very yes."  And probably you are stressing the imperative for change now rather than ten years from now.  That strikes me as an internally consistent set of views.

Yet I worry.  The implication is that the reform in the U.S. won't work nearly as well as in Europe, which made the switch to a different system much earlier on.  How much less well would a U.S. switch work?  I haven't seen useful estimates of this. 

Are there any data for the null hypothesis that past some point countries — for better or worse — simply cannot or will not change the basics of their health care institutions?

Almost everyone thinks that the French health care system is better than the British health care system.  What is the chance that the British could be persuaded to switch?  (Although I cannot imagine the rhetoric: "under the French health care system, Jean-Dominique Bauby would have been put to death.")  What does this say about health care reform more generally?

One unintended byproduct of the current U.S. debate is that the British will dally in reforming their NHS.  It is now harder for them to admit they have a relatively bad system.


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