I don’t think I “discount” the cost of litigation, I just don’t see the evidence that it’s a very significant cost driver in US health care, and even if I’m wrong, and it’s really 10%, if you “fix” that,you still have other more important and intractable drivers.
I’d say Canada’s system is more in the “Matrix” or even the “Camry”, than the “Trabant” or “Yugo”, cagatory.
Japan would definitely *not* be my choice of a model, it’s a highly fragmented system (several different insurance schemes) with relative high co-pays and a substantial number of people opting or left out at the margins. And Japan is probably the “First-World” country that cones closest to the US in terms of generating the occasional health insurance horror story - as best I can judge this results from a combination of economic-historical and cultural reasons plus the long recent economic stagnation (which is IMO a bit scary in terms of our own situation).
Perhaps what you say about Japan is why a proponent of a comprehensive reform like Kaiser would overlook it in selectively presenting comparisons between countries.
I also notice that Japan has higher # of hospital days; I’m guessing that translates into more missed days at work, and may be an added hidden cost to their cost-controls on doctors and hospitals, as I read most of their hospitals operate at a deficit (that’s happening to a lot of hospitals under Romneycare as well).
I also see that a surge of U.S. per capita spending is coming in with increased surgi-centers etc. Again I’m guessing fewer missed work days, again a hidden cost of lagging technology, which is really the point of my Trabant comparison—low innovation, low technology in the Canadian model.
Just for perspective , if you have Canada as a Camry , what do you consider U.S.?