America is now pulling away from Western Europe

That is the topic of my latest Bloomberg column, the energy discussion is obvious so here is the segment on health care systems:

The pandemic revealed years of capital underinvestment in many of European health-care systems. Many Americans used to admire the UK’s National Health Service, but right now the whole system is ailing. There has been a labor and capital shortage, and a collapse of emergency health care services, which may be costing up to 500 excess (non-Covid) deaths a week. Similar problems exist throughout Europe, though they seem to be worst in the UK.

The American hospital and health care system long has been good — too good — at making expensive, long-term investments in care and technology. Often this meant excess prices and not much of an improvement in basic care. But in the pandemic and post-pandemic environment, that feature of the system has kept US health care up and running. All that capital investment turns out to have been pretty useful in a major crisis.

The longstanding charge that the US does not have universal health care now is less relevant. Obamacare is highly imperfect along a variety of dimensions, but US health care coverage has never been higher — the percentage of the uninsured population is now 8%. Keep in mind that many of those uninsured may have decided not to purchase health insurance, instead preferring to spend their money in other ways. That might be a personal mistake, but that is not the same thing as a systemic failure of the entire US health care regime.

America actually has something pretty close to universal coverage, at least as an option. And remember that some of the European systems, most notably in Switzerland, also require significant out-of-pocket expenditures. Other parts of those systems are paid through relatively regressive systems of a value-added tax, so they are not as “free” as they might seem.



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