In what countries is healthcare "better" when private markets deliver it? Here, the term "better" has multiple meanings: cost vs quality/outcomes. Example: Some people say that the US has the "world's greatest healthcare" (whatever that really means), but most people can agree that the US poor cost performance (high cost, poor outcomes).
To editorialise for a moment, as I read about various public healthcare systems around the world, the diversity of systems is large, including outcomes. Almost none of them in highly developed countries are good and cheap. In these countries, healthcare is damn expensive, no matter how you do it. It's very difficult to spend less than 10% of GDP (that is huge for these countries) and have "good" healthcare.
Another topic about which academics have debated for decades: Same question as above, except primary/secondary/tertiary education.
Let’s look at actual problems with the US healthcare system. I’ll propose ways that if the market for healthcare were actually free, it would be better. It is not actually free because in the US, employers typically provide healthcare, and if you do not have an employer who does, the plans are prohibitively expensive.
Issue: People lose healthcare when they switch their jobs.
Solution: Have people purchase their own healthcare rather than receive it through their employer.
Issue: People don’t like their healthcare plan.
Solution: Allow individuals to choose their own healthcare plans. They know what they need far better than their employer does.
Issue: People cannot afford the healthcare plan they want.
Solutions: Stop throttling the amount of doctors who can attend medical school so that there is a sufficient supply of doctors. Higher supply will lower prices and improve outcomes. Institute outcome-based pricing schemes, i.e. providers get paid when they fix your problem. This will fix insurance companies’ and providers’ misaligned incentives; right now, their goal is to charge you as much as they can for health care and provide you as little as they can. That maximizes their margins. If they were only paid when they solved issues, I’m sure they would prioritize that.
IMO, the debate over “public” vs. “private” healthcare is a false dichotomy. The US does not have a private, free market healthcare system today, but proponents of public healthcare use the current state of it to argue against private systems, since it isn’t public. Proponents of private healthcare ignore anything that could improve the state of healthcare because they do not want to see it socialized and assume all suggestions will come in this form. The people in need of healthcare are left with poor healthcare as politicians fight imaginary healthcare dragons.
There is also a secondary issue in the healthcare discussion: prevention. Why do we have to spend so much on healthcare? It’s not like the human body spontaneously breaks down at such a fast rate. The actions we take as individuals, and as a society, cause a lot of disease. If we are concerned about healthcare prices, it is disingenuous and negligent of us to not look at what is driving our healthcare costs.
“ It’s not like the human body spontaneously breaks down at such a fast rate”
A significant amount of healthcare spending in the US takes place in the last years of life which is, indeed, just the body breaking down at a fast rate.
For those interested, I went and crunched the numbers. Statistics are from 2014, from [1] and [2], so a little outdated:
11.4% of medical spending on ages 0-18 (23.11% of population)
21.0% of medical spending on ages 19-44 (36.23% of population)
33.2% of medical spending on ages 45-64 (26.17% of population)
34.4% of medical spending on ages 65+ (14.5% of population)
So there is definitely more spend in older age, which makes sense, but the majority of spend is in populations I wouldn't consider old (<65). Additionally, what we consider "old" is really a reflection of average lifespan, and if we had healthier habits as a whole, maybe "old" would be older than "old" is today. By definition, old is when the body does start to break down at a fast rate, like you say, so I suppose it is tautologically true. However, I don't think it means we have to accept high healthcare costs related to that.
American healthcare is excellent at keeping people alive that would probably have died under other healthcare systems. That is, it extends the long tail out, with rapidly increasing marginal costs (in a "money is no object" situation). This is why a lot of people who could afford to go anywhere and obtain any medical treatment they want often come to the US for it.
It's not so good at keeping regular people healthy so that they don't need expensive care to begin with; though I'm not sure if this can be blamed on the "healthcare system" per se, versus cultural or educational factors. The average American is quite unhealthy.
It's quite bad at delivering routine care at reasonable prices. Get in a car wreck and break your leg? Want to deliver a baby at a hospital? It will get done at high standards and short wait times, but the bill if you're uninsured or underinsured will be eye-watering. This is a result of broken incentive systems surrounding healthcare in America, and probably deserves a lot of policy attention.
Currently, we don’t actually know the answer to that because the United States is subsidizing all of the research advancements in healthcare. We’re paying out the nose and the rest of the world gets the benefits at a discount.
In much the same way that environmental costs of business operations are subsidized across society instead of being born by the business itself.
To editorialise for a moment, as I read about various public healthcare systems around the world, the diversity of systems is large, including outcomes. Almost none of them in highly developed countries are good and cheap. In these countries, healthcare is damn expensive, no matter how you do it. It's very difficult to spend less than 10% of GDP (that is huge for these countries) and have "good" healthcare.
Another topic about which academics have debated for decades: Same question as above, except primary/secondary/tertiary education.