In his defense of a Canadian-style single payer system for health insurance appearing in today’s Projo, Dr. Michael M. Rachlis either makes a case that President Barack Obama is badly misguided in his belief that government has to get more heavily involved with medical decision-making as a part of healthcare reform, or else he calls his own basic assumptions into question…

On costs, Canada spends 10 percent of its economy on health care; the U.S. spends 16 percent. The extra 6 percent of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80 percent to 90 percent lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer….
Because most of the difference in spending is for nonpatient care, Canadians actually get more of most services. We see the doctor more often and take more drugs.…

If the problem of runaway costs is driven mostly by administration and overhead — as Dr. Rachlis plainly asserts — then by what rationale have government-commissioned effectiveness panels that will “bend the cost curve” by determining treatments to be denied (i.e., we’ve decided we’ll pay for the red pill, but not for the blue pill) become so central to the President’s discussion of healthcare reform?