Anyone unequivocally asserting what health care reform "will do" regarding cost containment is simply full of shit.

But, just consider some big picture numbers. We spend roughly 2x per capita on "health care" relative to comparable industrial nations (all of whom provide, in one manner or another, universal coverage). Now, what do we get for that expenditure? Low comparative aggregate clinical marks across the board relative to the rest of the developed world.

What can explain that disparity, other than "profit"?

We're currently at ~$2.5 trillion in NHE (National Health Expenditure) -- FIVE times the U.S. defense budget. The current policy battle to essentially lock in the for-profit status quo is no mystery to me. Lotta money on the table.

I've been studying this issue for 16 years. I still don't claim to have all the answers. But I try to not talk out my ass on stuff.

"Public Option" is viewed on a competition constraint on the for-profit intermediary sector. Perhaps only weakly so, in my view. And, with respect to "quality," its is pretty clear by now (and I've worked in the health care QI field), that clinical outcomes quality is not essentially a function of money per se.

You might want to start with my May 25th post and work forward from there.

You have a reading comprehension problem or something? You have obviously in this short span of time not done any thorough analytical reading of my posts. How did I begin?

Some reform advocates have long argued that we can indeed [1] extend health care coverage to all citizens, with [2] significantly increased quality of care, while at the same time [3] significantly reducing the national (and individual) cost. A trifecta "Win-Win-Win." Others find the very notion preposterous on its face.

"But again, how will the bills currently being debated reduce the amount that Americans pay per capita?"

The ARGUMENT is that it will serve as a constraint on the private sector. Not everyone is persuaded, me among them. But the issue is MUCH more complicated than that.

Look, the 1994 Elhauge paper addressed these very issues of endless cost, in considerable detail. e.g.,

...we must rely on market, professional, and/or political paradigms for making resource allocation decisions. But why should we have any more faith in those decision-making processes, and what role should we ascribe to which process? Clearly, a full justification for the healthcare system I advocate requires more than an assessment of the strengths and weaknesses of the moral paradigm, which is all this article offers. It requires a comparative assessment of the strengths and weaknesses of the other paradigms. The details of a full comparative paradigm analysis will have to await another day, but a sketch of the argument is probably necessary to provide context to this article’s analysis of the moral paradigm.

As I see it, the strength of the market paradigm are the standard ones: if consumers are knowledgeable, have similar resources, and have incentives to trade off the benefits and costs of each product, then market competition promotes productive efficiency, accommodates varying consumer preferences, and achieves allocative efficiency. The problem of unequal resources is largely external to the market paradigm and potentially remediable through vouchers. But the more fundamental problem of the healthcare market flows from an inherent division between knowledge and incentives. Unlike other markets no decisionmaker exists who has both the knowledge and the incentives to decide when the costs of supplying a particular good or service exceed its social value. Patients lack the knowledge and, even the fact that others (such as insurers or employers) cover much of the social costs, also generally lack the necessary incentives. Physicians and other healthcare providers are knowledgeable about medicine but not about social benefits and costs. Moreover, under current American market systems they either have incentives to provide too much care (if paid on a fee-for-service basis) or incentives to provide too little care (if paid on a capitation basis). Insurance plans generally lack the information to make case-by-case cost than if it decisions and have incentives to provide two little care, or to select for low-risk enrollees unlikely to need much care, because the insurers pay the cost of health care but do not enjoy its benefits…

… Where markets and self-regulation fail, it is natural to turn to the political process. The main advantages of the political paradigm are (1) that it can make the open-ended trade-offs between healthcare and other social goods that do not lend themselves to objective scientific analysis and (2) that, unlike decision-makers under market and professional paradigms, political decision-makers have incentives to weigh benefits against costs because both are experienced by the polity. The disadvantages are that the political process is inevitably too centralized to effectively trade off the benefits and costs of health care in individual cases, and is susceptible to problems of majoritarian bias, intransitive choices, an interest group politics. These weaknesses counsel for limiting the political process to one global issue: how high to set a national (or state) level of health care spending and associated tax. This avoids the political processes in ability to make operational decisions, and lessens the concern of majoritarian bias because funding levels are more likely to affect everyone equally and decisions about which treatments to fund. This way of framing the political decision is also more likely to produce both “single peaked” preferences resistant to intransitivity problems and, more important, Lowell political information costs that render the process less susceptible to interest group dominance. [pp 1542-4]

You want some one-paragraph easy unequivocal answer, you are not gonna find it anywhere.

"Public Option will lead to Single payer guarenteed [sic]."

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Increasingly sounds like a good idea to me. Why don't we just cut to the chase?

You are clearly not interested in debate. Your mind is made up. I'm not "losing" anything. Just ignore me from now on. My rational interest is in affordable universal coverage, however it's structured. Niggling around at the margins on a for-profit actuarial model "system" cannot get there.