Victor Fuchs (Health Affairs Blog 4/28/21)

• national health expenditures have increased at an average of 4 percent per annum [vs] GDP [by] 2 percent per annum … over the last 70 years.
• U.S. community hospitals had an average occupancy rate of 65 percent [pre-pandemic].
• In 2017, 5 percent of patients accounted for more than 50 percent of expenditures. 
• Fee-for-service payment doesn’t always result in very high expenditures, as demonstrated in France, Germany, Japan, and several smaller countries that pay for physician visits that way.
• Major reform is … opposed by millions of workers who mistakenly believe that employers bear the cost of so-called “employer-provided” insurance. Most economists believe that workers actually bear the cost in the form of stagnant wages. 
• U.S. health care is too costly (18 percent of GDP rather than 12 percent), too unequal, and comes with too much uncertainty about insurance eligibility and coverage.
• Limiting but not eliminating patient choice of provider, and limiting or preferably replacing payment for volume, should both be part of the solution.
• A system of competing, capitated plans offering comprehensive care is the most promising vehicle for the United States to reform its health care system and control health care spending.

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