Establishing a National Health System
Although it is unlikely that the United States would ever go so far as to establish a national health system as Britain has done, Britain’s experience illustrates the benefits of centralizing control. And all of the countries described in this chapter (except the DRC) illustrate how establishing government control over both op- erating and capital budgets for hospitals and other facilities can restrict the dupli- cation of services and proliferation of technologies that have driven up the costs of the existing system. By the same token, establishing a national fee schedule for service providers, such as Canada uses, would enable the government to restrict the rise of those fees. Even more control is possible if the government, like Brit- ain’s, restricts doctors to salaried practices so they can’t increase their incomes by increasing the number of procedures they perform. At the same time, mandating national health coverage, regardless of the nature of the system, would guarantee a large enough risk pool to make community rating feasible and affordable. Finally, using income taxes to pay for health care would more equitably distribute the costs of financing the system.
