Would it outweigh the diseconomies of scale seen in the NHS? It is pretty clear that the less centralised systems in other western European countries are more efficient, nor can I see any evidence that smaller western European countries face consistently higher costs than larger ones.
What are you seeing as the drivers of those diseconomies of scale? That might help me better answer the question.
Again, though, I think it’s an error to treat each country as if it’s interchangeable. In other words, we need to understand the systemic causes of those costs to understand the impact as it relates to other nations.
In the above example with Medicare, the cause is due to negotiating power through volume. So it’s pretty clear that scale matters there.
