The last OECD study I looked at actually had a few countries (Luxembourg, Norway) with higher public spending per beneficiary than the U.S. But, given the relatively low percentage of the populous who benefit from public spending in the U.S. compared to other countries, the reason the per-capita spending is so high here is because health care costs themselves are so high. Americans go for physician visits and hospital stays less than citizens of other OECD countries because of high tech costs, general lack of cost inflation control measures--and less coverage--here. And still, for all that spending and tech, we get less satisfactory health outcomes here in lots of important measures than other countries anyway. Importantly, these other countries have broader-based tax systems than the U.S. too, which makes spending on beneficiaries easier to finance. The American left is, in my view, often blind to the fact that, in order to get better broad-based benefits, everyone, and not just the top few percent of income earners, needs to pay more taxes. But we also need to contain costs much more effectively than we do, and if we're not willing to do that, which we've proven that we're not, than any framework we come up with will bankrupt us in the long, or not-so-long, run.
I appreciate your sober interpretation of federal policy, but we have a wide tax statutory base. That's the problem. The wide tax base and onerous regulations for unskilled workers are smothering the lower classes, giving the appearance of a narrowing statutory tax base.
It pains me to say it, but one way to narrow the statutory tax base would be single payer. Single-payer would simultaneously eliminate the Obamacare employer mandate and transfer more economic benefit to the lower classes. As employment rates and labor force rise so will tax revenue.
Single payer is lousy compared to a functional private system, but we wrecked private sector medicine with bad regs long ago so we're stuck taxing the bottom quintiles without providing any benefits.
