>It seems to me that it's only the United States that failed to control costs.
This is a pretty well established fact in Canadian health econ literature. There's a number of reasons why Canada and system like Canada' are able to do this; a single payer for most health insurance and pharma products, acute care organized into regional structures in most provinces that create economies of scale, the structure of in and outpatient care, and efficiency levels expressed as unit costs and overhead costs that HMO's would die (or just not treat) for. In the 90's the reductions in expenditure as a % of GDP were achieved though absolute and relative reductions in the amounts paid to MD's and other non-employee health professionals, delaying capital projects, reductions in staffing levels and de-skilling work to lower paid, and fewer, workers.
>In my view, spending roughly 10% of GDP on health care (as Canada did in the past) isn't necessarily bad, which all rich nations should be able to >afford, provided that the money is spent to make everyone healthier and happier, rather than on administrative costs incurred to determine people's >eligibility for services, deny them care, and make profits.
Well it isn't necessarily bad, but it's a pretty crude measure, even within Canada we have significant variations in the amounts per provincial GDP, per capita and so on. It's a pretty crude measure but it gives you a rough sense of what's going with health as it relates to the economy. Our percentage has started to increase in the last 2-3 years, largely in part (IMHO) because capital projects that were deferred in the 90's are now going ahead. Those expenditures turn up as part of the % of GDP but arguably have little to do with improved health care or outcomes.
As noted above our overhead costs are pretty low, most provinces estimate they're around 2-3% for administering provincial health care plans. As far as I know no HMO can approach that, and it's the about the best (non-philosophical) argument against privatization.
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