Tuesday, May 26, 2020

A National Health Service

One of the unexpected consequences of the response to the novel corona virus has been the effect of the cancellation of all elective procedures in anticipation of a flood of covid-19 patients. Combined with lock-downs and a fear of going to public places, hospitals are loosing revenue and some may go bankrupt. If a significant sector of the economy (about 20% of GDP) goes broke, that will have long term implications for the recovery, not to mention health care delivery. 

Contrast that to the state run National Health Service. Not only does health care in the UK (like most of the rest of the developed world) only account for about half what it costs Americans, there is no danger that hospitals will "go out of business". 

The NHS may not provide some of the cutting edge procedures that elite, but it does provide at least as good care to every member of society in the UK as the American private healthcare system does for those lucky enough to have health insurance but not wealthy enough to pay for "premium" treatment. And it provides immeasurable better care than can be accessed by those without money and without health insurance.

Suppose, for a moment that many of America's hospitals do go broke. What can be done? First, there is an odd echo of under-capitalization of systemically important financial institutions here. So might government, state of federal, bail them out? It's possible; and perhaps there might be similar provision sin the legislation appropriating the bailout funds requiring hospitals undergo an equivalent stress-testing procedure, and that they maintain adequate reserves to continue operations during a similar event in the future.

Another option, however, would be to acquire those failing hospitals to begin the construction of a state-run health service. This might best be done at the stare rather than the federal level. And they one could make some useful comparisons in the US context of two different approaches to health care delivery.

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