It is known that many national healthcare systems are able to save money because of their monopsonistic market powers, which by definition bidd down price and reduce the quantity healthcare from what a competitive market would suggest. One consequence of this is less innovation: if you have fewer profits, you have less to reinvest in research and development. Since information diffuses freely, that implies that the US, through its higher healthcare costs, is subsidizing much of the innovation that the EU benefits from.The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.
If you disagree, how do you account for the differential in innovation between the two areas, when the EU has a greater population and GDP than the United States? If you agree, then the US going to a monopsonistic single-payer system would decrease the rate of global healthcare innovation (companies may raise prices overseas and get some revenue back, but not enough to compensate for the losses.) Where, then, does the utilitarian calculus stand?