Why Americans don't really want socialized (single-payer) medical care, from Hendrickson at TCS:
The lesson learned from HMOs not only provides evidence that Americans are likely to reject a single-payer system, but also sheds light on why the United States spends more than any other country on health care. Americans spend more because they have a higher demand for health services. This fact should come as no surprise. Americans have generous health care plans and their premiums are predominantly paid by their employer. This insulation from cost gives Americans little incentive to seek cost-effective treatment and thus routinely results in patients receiving a series of high-tech tests and treatments, which economist Arnold Kling refers to as "premium medicine".
A single-payer system is clearly at odds with Kling's "premium medicine" hypothesis. Such systems "solve" the problem of higher health care expenditures not by providing incentives to do so, but rather by restricting treatment. Thus, in a sense, they treat the symptom of the problem rather than the problem itself. Equally important and detrimental is the fact that restricting or delaying treatment may save on monetary costs, but it not without a cost to others. Patients whose treatment is delayed or rejected will incur a cost and, if HMOs were any indication, they will largely become dissatisfied with the system. Similarly, pharmaceutical companies and health equipment researchers and manufacturers will have a disincentive to produce and innovate. One could easily argue that the lack of new innovations and technology would come at a much larger cost in the long run than would be "saved" by a single-payer system.
The whole thing is here.
