Universal Health Insurance?
Posted August 22nd, 2009 @ 03:37pm by Erik J. Barzeski
A unique perspective compares universal health care (by way of universal health insurance) to universal auto insurance. Summary: didn't work there, won't work for health care.
Thanks Daniel.
Posted 25 Aug 2009 at 5:01pm #
Hmm. Germany and Switzerland have private (non-profit) companies running health insurance, and things seem to be fine there.
PBS' "Frontline" had a good series on how various countries do things that's worth a watch:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
The common characteristics between most countries who have universal coverage are:
. no profit on essential care; profit, if any, on "extras" only
. everyone mandated to buy in (poor covered by gov't, no different than Medicaid)
. must accept everyone: no cherry-picking young/healthy
. negotiated fixed-prices for services: no pure-market
Posted 25 Aug 2009 at 5:44pm #
@David: yes, indeed.
It's funny that so many Americans think this won't work. Do you ever look abroad? Do you really think you are the first to implement such a system?
This is nothing special. It really isn't. We have had this in place for decades.
Posted 25 Aug 2009 at 6:47pm #
Another comparison would be 100% privatized Fire (Department) Insurance...
Having to worry about calling an in-network fire department, or get stuck with a huge bill after the fact... well that seems to be about as silly a comparison as universal car insurance, but on the other side of the coin.
Posted 25 Aug 2009 at 8:20pm #
I'm sorry but that comparison is terrible. People are going to lose their jobs because they get fined for not having health insurance???
That sounds more like the current American health system than anything else to me. Can't remember reading about NHS patients in the UK having to sell their homes or lose their jobs to pay their medical bills. Can't say the same for the current system in the US.
Posted 25 Aug 2009 at 8:35pm #
I never said it was a valid comparison, people. I said it was "unique."
And Canada has universal health care, don't they? Yet it's well known that if Canadians want GOOD care and they don't want to wait six months for basic stuff, they come to the U.S.
I think health care costs are way, way too high, but I'm against any sort of universal health care. I think quality of care will nosedive, wait times will skyrocket, and the system will be abused like virtually every other type of government program.
Posted 25 Aug 2009 at 9:24pm #
Define "basic stuff". Out of the thirty million Canadians (who are all covered), what percentage actually go down to the US? Where you're put on any waiting list is generally determined by the urgency of your illness. Decisions are made by the doctors and specialists you visit, and not bureaucrats. I think the main problem of the Canadian system (at least in Ontario) is that the medical schools aren't letting enough students in--we'd be able to solve a lot of problems by simply increasing the supply of doctors (both family and specialists).
Also, why does everyone seem to use the Canadian system as an example? What are the wait times in Germany? Japan? Switzerland?
The US is paying up to twice as much more, with fewer results (higher infant mortality, shorter life spans, tens of millions with no access--except the ER, which actually drives costs up).
I highly recommend you check out the PBS series on things can be done. You do NOT have to have the government run things. Both Germany and the Swiss have PRIVATE COMPANIES running the insurance system. There are MANY ways to have a universal system. The overhead of the current US HMO insurance systems is something like 20%; in Switzerland the average is 5%. The US can actually LOWER its costs.
AFAIK, the only time you have the government stepping in those countries is for the poor--which is happening already in the US with Medicaid.
I do believe in universal coverage, and as a Canadian I can see the benefits (even if our system isn't perfect). I think the debate should be on how to implement it.
Personally I agree that a government or single-payer system will probably will not work in the US (especially if the Feds attempt to run it). However, I do think that that there are models out there that can be used to give more citizens access to proper care and lower overall costs as well.
Posted 25 Aug 2009 at 9:51pm #
[quote comment="55154"]Out of the thirty million Canadians (who are all covered), what percentage actually go down to the US?[/quote]
You're probably gonna get different numbers based on how far they are from the border, don't you think? I don't know what the numbers are. But I know a few doctors and they're surprised at how many people make the trip. In Buffalo, it's only a 20-minute drive. Here in Erie, it's about 90 minutes (you have to go around Lake Erie).
[quote comment="55154"]Where you're put on any waiting list is generally determined by the urgency of your illness.[/quote]
Waiting tends to stink regardless. I don't think anyone's going to want to hear "you're not sick enough for us to treat you."
[quote comment="55154"]Also, why does everyone seem to use the Canadian system as an example?[/quote]
Because they're in North America? Because they tax people about the same amount as in the U.S. What's the income tax rate in Switzerland - 65%?
In the end, I don't really care much. My wife and I have jobs and we'll have health care one way or the other. I think it will suck if quality goes down, but beyond that, I don't much care so long as things remain "reasonable." And since that's my word and how I define it is different, I'm not going to bother spelling it all out.
Posted 25 Aug 2009 at 11:43pm #
As a Canadian that didn't move to the US until his mid twenties, I love these conversations, but it's one that requires a beer in hand to have in great detail.
That said, we all pay enough taxes, so even if they could find a way for this to work in theory - I'm going to object to most methods needed to fund it.
Posted 27 Aug 2009 at 11:17am #
I was having this discussion with a friend recently, and brought up an important point. Sure this stuff works in Europe... where people are generally more healthy than Americans are. We in America are, generally, somewhere between slightly obese and morbidly obese. Europeans are much more likely to be healthy.
We eat 2,000-calorie fast food combo meals, and we sit on our hindsides watching TV all night every night -- and then we expect to be able to pop a pill that undoes our lifestyle choices.
That's not how the rest of the world does it, and it won't work here. ObamaCare/KennedyCare will bankrupt America unless we are first willing to make better lifestyle choices.