Jonathan Cohn writes,

French universal health insurance works an awful lot like Medicare does in this country. And that’s the great irony of how screwy the debate over health care has become in this country. Conservatives always talk about expanding choice, yet when it comes to the choices Americans prize most — choice of doctor and hospital — government-run health care actually delivers that choice better than private health insurance.

Last year, I scaled up the French population to our level, and then created the following table of medical expenditures:

Country Health Care Spending
$ billions
France* 900
U.S.–Medicare 300
U.S.–non-Medicare 1600

*with 300 million people

If Medicare were a country, it would already be way over the top in terms of health care spending. If we were to keep Medicare as it is and then introduce the French level of total spending then we would have to cut spending on the non-Medicare population by roughly 67 percent. Is that what Cohn is talking about? I doubt it. But I can never figure out what single-payer advocates are talking about, because they so often evade the basic issues of how it is supposed to operate.

I really want the advocates of single-payer health care to get into specifics about spending, taxes, methods for compensating health care providers, and all of the other mechanics that need to be worked out if the government is going to take over health care finance. It is irresponsible to just blithely say, “It works in Europe, so it can work here.”