“Global budgets” refer to an arrangement under which each hospital is allocated a fixed amount of funds for the whole year. If the number of patients with heart attacks or opioid overdoses increases, hospitals wouldn’t get any extra revenues to treat them. This would encourage hospitals to withhold treatment from patients who need scheduled operations to save money for emergencies.
That’s why single-payer health-care systems are notorious for long waiting lists. In Canada, patients must wait an average of four weeks for an ultrasound, 11 weeks for an magnetic-resonance imaging scan, 26 weeks for brain surgery and 39 weeks for joint surgery. Long waits impose pain, uncertainty and anguish on patients and their loved ones—and often means diseases get worse.
Over the past generation, France, the Netherlands and Sweden have moved away from global budgets, reasoning that medical providers are more productive when paid for the work they do. None are seeking to return to this method of cost control.
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