Ezra Klein writes,

Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more…

American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves.

He is right about Britain and Canada. He is wrong about America. In America, about 90 percent of health care spending is paid for by third parties–most individuals do not fend for themselves. He also writes as if those who [don’t] have health insurance do without health care. They do with less than other Americans, but it is not accurate to say that they do without. [Freudian slip corrected]

My view of the American health care system is that it hardly rations health care at all. That is why we spend so much more than other countries. I wish we put more responsibility on individuals. Instead, we have this delusion that we cannot possibly afford health care if we pay for it individually, but of course we can afford it if we pay for it collectively.