The New York Times had a column Sunday that pointed out that other wealthy countries have better health care outcomes than the United States, at a much lower per person cost. While the column included much useful information, it concluded that the main obstacle to reform in the United States is that the public does not have confidence in a government managed health care system. I would suggest an alternative hypothesis -- the vast majority of the public has no idea how inefficient the U.S. health care system is relative to the systems elsewhere in the world. I have been reading the NYT almost every day for more than 30 years; this is one of the few times I can recall any mention of the relative inefficiency of the U.S. health care system. On the rare occasions when the NYT talks about the health care system in another wealthy country (e.g. Canada, Sweden, England), the article is usually focused on the system's problems, and generally implies that its demise is imminent. I would be very surprised if even 10 percent of the NYT's readers knew that per person health care expenses in the U.S. are more than 60 percent higher than in Canada and more than twice as high as in England, and that both countries enjoy longer life expectanies. Furthermore, the NYT has a policy of either ridiculing or ignoring politicians who propose reorganizing the U.S. system along the lines that have proven successful in other countries. Remember the extensive coverage given to 2004 Democratic presidential candidate Dennis Kucinich's plan for a universal Medicare system? No one else does either. It was barely mentioned in the media. (e.g. This NYT piece includes just a sentence on the topic. This Washington Post article wrongly tells readers that Kucinich doesn't say how he would pay for his proposal. A claim that could have been disproven with a quick trip to the candidate's website.) Of course most of the public is far less informed than regular readers of the NYT. That is why it is safe to assume that they have no idea how inefficient the U.S. health care system is by international standards. Before we follow this column and assert that the obstacle to health care reform is the "American psyche," it would be nice to see the media make some serious efforts to inform the American public on the relative quality and cost of its health care system. It has failed badly in this task so far.
--Dean Baker
