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Freakonomics blog, new york times, September 26, 2008,  12:22 pm

Your Country Would Like to Treat You to a Doctor’s Appointment

By Daniel Hamermesh

The financial crisis is getting all the headlines and, so it is claimed, occupying all the attention of at least one presidential candidate.

Yet a bigger economic issue is hardly being addressed: the exploding costs of health care in the U.S., where we spend a far greater share of our incomes on health than people in other rich countries. How do other countries avoid having health care attract an ever-growing share of resources under their systems of universal coverage and still produce health outcomes at least as good as ours?

One way was made clear yesterday, when, as a (temporary) citizen of Bonn, Germany, my wife received a letter saying she had been scheduled for a free mammogram at a particular time and place. With a preset appointment, no effort is required to arrange things; this arrangement would certainly not exist for most people at home.

Substituting the small cost of preventive care for the large costs of curative care for all citizens seems like a sensible way to contain medical costs under a universal health care system.

Maybe, as I think will happen, the U.S. will finally provide access to health care for all citizens; and it may be possible to do so without shifting still more resources into this sector.