How so? The public sector has no secret information on cost cutting that the private sector doesn't have.
No secret, the public system would not be run for a profit
. Subtract the profit and you already have a small part of the cost cut that the private sector has no motivation to provide. And because you aren't competing with anyone you don't need a nice building in a good location, you don't need any marketing, and you don't have the latest technology.
So where is this room for lower cost that you're talking about?
Besides eliminating profit, the public health care system can be cheaper by paying under market value for their labor and by providing a lower level of service than the private sector provides. They would not attract the best and the brightest similar to how public solicitors earn less than the private sector on average and there would be a similar motivation to avail yourself of private care if you can afford it.
In short, when you eliminate the need to compete for a profit, you can lower a lot of the operating costs of the system. You don't need to outdo the rival institutions, you don't need the latest technology and any advertising and you don't need the best and the brightest doctors and staff. You are the Southwest airlines of health care but you don't even need to turn a profit like them. You can cut all the frills because you don't need to care about your brand.
Sure, but it could just as easily be trimmed with a public health insurance plan that pays only the bare-bones part of the patients' medical bills.
But the bare bones service in the same nice hospital by the same well-paid doctor is not going to be as cheap as the government clinic in a run-down part of town that is employing doctors of lesser cost and quality.
The different level of service you can provide when you aren't competing and don't need to provide the same level of service can cut costs dramatically.
You're right. I mangled it on editing. It should have been: "In countries where governments employ the doctors, healthcare is not consistently cheaper than in countries where governments pay the patients' medical bills, but don't necessarily employ the doctors." (For clarity: Costs seem to be roughly similar in both systems, and both systems are substantially cheaper than America's, in which health insurance and health care providers typically work through the private sector.)
I don't advocate that the government employ all doctors and in every place I have lived where the government employs some doctors yet others are in private practice the public system is cheaper.
For example, here in Costa Rica the government has a monopoly on insurance, and also provides public health care to its citizens. The monopoly and economy of scale of the insurance does make it very cheap but it's still much cheaper to go to the public hospitals with doctors employed by the government than it is to go to the private hospitals.
So those who can afford it seek private care, and those who can't have a free safety net that is not as nice and comfortable but that does its job of keeping people alive and healthy relatively well.
I don't know of any example of a dual system like that where the private system is not more expensive than the public one but I don't know that many examples myself. Do you know of any such example where the public sector is not cheaper?