As this is a continuing topic of conversation in the US and with Americans who ask me my thoughts on these issues as a Canadian, I’ll continue to post here links to resources that I find helpful in explaining these differences. This interview with Princeton professor Uwe Reinhardt, a top American expert on health care economics, explains in a way that I’ve not heard before in the same detail just why the administrative costs are so high in the United States and why a national health care system could easily save enough money to bring affordable universal health care to everyone in the US. If this is something that interests you, make sure to take the time to read or watch this extensive interview.

This part of the interview, which was featured in this other shorter news story on the Canadian system that I’ve embedded below, explains it all:

Edie Magnus: We were in a hospital that was affiliated with McGill University, and it was a regional system that had six hospitals that were affiliated with one another, and they annually have some 39,000 inpatients, and they do about 34,000 surgeries and they deliver about 3,000 babies. And managing all of this is a staff of 12 people doing the billing, the administration. What would an equivalent hospital in the U.S. take to run administratively?

Uwe Reinhardt: You’d be talking 800, 900 people, just for the billing, with that many hospitals and being an academic health center. We were recently at a conference at Duke University and the president of DukeUniversity, Bill Brody, said they are dealing with 700 distinct managed care contracts. Now think about this. When you deal with that many insurers you have to negotiate rates with each of them. In Baltimore, they are lucky. They have rate regulations, so they don’t have to do it. But take Duke University, for example, has more than 500,000 and I believe it’s 900 billing clerks for their system.