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View Diary: The lost conservative (really) (74 comments)

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  •  Actually, I'd argue the opposite. (1+ / 0-)
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    The Geogre

    First of all, I want to note that we often underestimate just how big Japan is in terms of human logistics. It may be geographically small, but it has more than half of our population.

    But more importantly, the whole purpose of single-payer health care is to get economies of scale. A larger country is typically able to negotiate better drug prices with manufacturers, for example. And the risk pool is larger; costs averaged out over more people become far more predictable. There's one further benefit to a large risk pool: consider the the medical costs of a natural disaster in a limited geographic area. The same event that could overwhelm a state-run health care system might not even make a big dent in the budget of a federal system.

    We do in fact have an example that demonstrates the benefits of scale: Canada. Canadian single-payer health care didn't come all at once. It was introduced by provincial legislatures, province by province; that's much like what Vermont has set in motion and what California, Pennsylvania, and New York are all trying to do. But Canadian single-payer health care didn't achieve its full benefit until the national government took it over from the provinces. By that time all or almost all of the provinces had implemented single payer.

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