It shows exactly what is wrong with America's

conversation about health care.

On one level, you've seen this chart before.

It shows health care spending as a share

of the economy of a bunch of countries.

There's Germany and France and Japan and Canada

and oh! There's America.

But now I want to add something you haven't

seen to this chart.

This is how much of that spending in each country

is private and how much is public.

Here's what's amazing:

America's government spending on health care

on programs like Medicaid and Medicare and the VA -

our versions of socialized medicine.

It's about the same size as these other countries.

These countries where the government runs

the whole health care system!

And then there's our private spending.

It's the private insurance system that makes

health care in America so expensive.

Conventional wisdom says that the government is

more expensive than the private sector.

"It can't say no. It's corrupt, it's inefficient, it's slow."

"If you want something done right

you give it to the private sector."

That is what we hear in America all the time.

And yet here we are with the biggest private sector spending the most.

If you look at the data on physician visits

and hospital discharges, you can get rid of one theory.

Americans don't consume more health care

than people in these other countries.

We don't go to the doctor more than the Germans

or the Japanese. In fact we go to the doctor less.

The difference between us and them

is that we pay more.

Every time we go to the doctor for everything

from an angioplasty to a hip replacement

from a c-section

to a pain reliever.

In America, the price for the same procedure

at the same hospital, it varies enormously

depending on who is footing the bill.

The price for someone with public insurance

like Medicare or Medicaid is often the lowest price.

These groups he covers so many people

that the government can demand lower prices from hospitals and doctors

and they get those lower prices.

If the doctors and hospitals say 'No'

they lose a ton of business.

They lose all those people on Medicare

all those people on Medicaid.

But there are hundreds of private insurance companies

And they each cover far fewer people than

a Medicare or a Medicaid.

And each one has to negotiate prices

and hospitals and doctors are on their own.

And if you're uninsured, you have even less leverage.

Nobody is negotiating on your behalf.

So you end up paying the highest price.

One study found that most hospitals charge uninsured

patients four times

as much as Medicare patients for an ER visit.

Other countries, they don't have this problem.

Instead of every private insurance company

negotiating with every healthcare provider.

There's just this big list.

The country, the central government, they go

and they say, "If you want to sell to us, to all

of our people, then here's what you can charge

for a checkup. Here is what you can charge for an MRI

or a prescription for Lipitor.

And so then whether that bill goes to the

heavily regulated private insurance

companies in Germany or directly to the government

like in the UK.

Each country is telling the doctor or hospital

or drug company how much that bill will be.

And because the government controls access

to all of the customers. It's an offer that hospitals

and doctors and pharmaceutical companies

typically can't refuse.

"I'm going to make him an offer he can't refuse."

In America the idea is that you'll be a consumer.

That you'll do what you do when you go to Best Buy and buy a television.

But that just doesn't work in healthcare.

It doesn't work in healthcare because

you often come and get health care when you're

unconscious, in an ambulance,

when you're scared,

when it's for your spouse or your child

It is a time when you have the least bargaining power.

You are not usually capable of saying, 'No.'

You're not knowledgeable enough to do it,

you're not comfortable doing it,

or you're not conscious enough to do it.

That's why in other countries the government is a

person who can say 'No' for you.

You can say, 'No, that's too expensive

you're going to have to lower your price'

because they do have that power.

Anchor: A new push for single-payer health care

right here in the US.

Demonstrator: What do we want?

Crowd: Single-payer!

Demonstrator: When do we want it?

Crowd: Now!

Anchor: California and others are saying maybe

we should adopt the European model.

Klein: If we decided to create a single-payer system

with one of these huge price lists in the US

There would be nothing to stop

lobbying from hospitals from doctors from

drug companies. And those prices would get influenced.

So we could end up with a single-payer system

that is expensive. Even as expensive as

our current system.

It all depends on how much you negotiate down

the prices and now in America

these groups have so much power because they are so rich.

That it's really hard to get them to bring down the prices.

This is the irony of American healthcare:

It's so expensive that it's become hard to make it cheaper.

All that money they make, that becomes political power.

And years and years and years of overpaying -

those are huge industries now.

And they have a lot of influence in Congress.

Under a single-payer system

if we did drive prices down, doctors and hospitals

they would be paid less than they are right now.

That might mean some of them close

or some go out of business or some move.

It would be really painful. One person's waste

is another person's essential service or local hospital

or their income. But then single-payer

it's not an all-or-nothing choice.

For instance, there's a really interesting section

of Bernie Sanders Medicare-for-all bill.

Where he lays out this interim plan.

It's a plan he wants while he's setting up

his new single-payer system.

And in that plan, he expands Medicare

to cover vision and dental.

And he opens it to nearly everyone.

Not just people 65 and older.

All kids go on Medicare automatically

and most adults can buy in.

That plan, on its own, it wouldn't get American

health care spending far down overnight.

But it would at least begin to recognize

what we already know

and what most other countries already do:

That health care is one of those things the government

can do cheaper and better than the private sector.