Impossible to know how doctors will actually behave with respect to actual tests, so I don't want to go out on a limb in estimating actual realized savings. I think you're stretching with the granny stuff, though. Whether the UK system would fly here is again impossible to know, but my opinion on this is strongly held, being based on direct experience. As for my pessimism relative to outcomes in other
countries, we're second to none in many important things, including government-supported science and technology, but with healthcare we need to be realistic in view of our size, diversity, and relative inexperience with large civilian bureaucracies, as well as the gravitational pull of talent to the private sector. One can argue that distrust of government--a legacy of the country's founding, and greatly in evidence today--is smack in the middle of a reinforcing cycle, but I don't see how you change that either, except by setting more modest goals and achieving them first.
Originally Posted by stephanie
Yes, everything I've seen indicates that any argument that there are significant costs based on lawsuits or the threat thereof have to be tied to defensive medicine and not actual malpractice damages, settlement, and malpractice insurance.
So that being the case, and assuming arguendo that it's true, how would reform tort law so as to fix the problem? Do you think that people will be comfortable and happy knowing that they will probably get less defensive medicine and put up with a higher risk of missed diagnoses, however cost-effective that change would be? Do you not see that as somewhat inconsistent with the current rightwing line that the gov't might not pay for as many tests and other care for granny (otherwise known as "death panels")?
I actually think that if the UK system had been the system in the US, people would be arguing it was the best in the world. People mostly seem to accept and be comfortable with what is, in terms of what they have and until a specific problem arises. Plus, we like to think that whatever we have is the best in the world.
But that aside, you touch on something I find intriguing about this debate -- given the difficulty in arguing their preferred argument (that government, inherently, is incompetent) based on the competence demonstrated by numerous governments in this arena (say Sweden, sure, and the Netherlands, and France, among many, many others), the implied argument seems to be that we somehow are less competent. Kudos for saying it straight out. But why would that be? Historically Americans are pretty confident in our ability to do hard things, not convinced that we can't manage what other countries seem able to do just fine.