posted on September 20, 2009 05:47:45 PM new
I think this reporter's book, coming out this week, will be an interesting read!
5 Myths About Health Care Around the World
By T.R. Reid
Sunday, August 23, 2009
As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"
3. Foreign health-care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.
Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.
The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.
Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.
T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," to be published Monday.
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"Here in America we are descended in blood and in spirit from revolutionists and rebels - men and women who ***dared to dissent*** from accepted doctrine. As their heirs, ***may we never confuse honest dissent with disloyal subversion."*** --Eisenhower
posted on September 20, 2009 09:03:32 PM new
Pres. Obama and the Democrats in Congress are similar to the Pied Piper.
While they are blindly cheered on by their liberal minions, they are leading the country to the precipice and then stepping aside so that the rest of us stumble to our fate.
As I have posted before, when it comes to health care, Congress knows what is best for us, and what is better for them.
When the princes and princesses of Congress place themselves into the same plan as all of us; only then can we be sure that the proposed health plan is a good plan.
posted on September 21, 2009 07:08:47 AM new
Steve Kagen, a Democratic member of Congress has refused to accept federal healthcare benefits. "If every member of Congress put their heads on their pillow every night like I do . . . knowing this could be the night I lose my house, we'd fix healthcare in a week," said Kagen, who spent decades as a doctor in the Green Bay area before winning election in 2006.
Actually, Kagen is being too kind to his fellow members of Congress who are secure with their personal Congressional health plan but even more with the prospect of continued payola from the insurance industry. A vote for a public option would result in an "economic downturn" in their back pockets.
"Lawmakers can choose among several plans and get special treatment at federal medical facilities. In 2008, taxpayers spent about $15 billion to insure 8.5 million federal workers and their dependents."
posted on September 30, 2009 08:33:53 PM new
Everything looks good from the distance until you start digging,my friend went up to Canada to see her father and she is pretty disgusted with the Canadian system .
I know some Canadians would rather seek treatment in the States than be on the waiting list.
I also know some Japanese cancer patients who come to MD Anderson for cancer treatment just to find out Japnanese insurance would not pay for it and they cannot afford to pay themselves.
*
There is no 'Global savings glut',only wild horses and loose bankers.
posted on September 30, 2009 10:09:38 PM new
Well, here is a proposal that is not a myth. Apparently, many in Congress believe that seniors will become less dependent upon Medicare, as it is proposed that money to fund Medicare will be decreased as more of us age, and need care in our senior years. Or, programs for seniors will be reduced, or cut.
"A compromise plan has been put forward by Max Baucus, chairman of the powerful finance committee. The plan would establish a national insurance exchange and would offer subsidies to those without insurance.
To help raise money to implement the plan, payments to the Medicare programme for retirees would be reduced ... "
posted on October 5, 2009 06:23:45 PM new
It is hard to believe we spent so much time discussing healthcare.
You would think the most powerful nation on this planet will have better things to do than to talk about sickness and disease?
How did we manage to build this wonderful nation,send people to the moon,grab all those gold medals in the Olympic,lug all 16 bags of grocery from Walmart,Safeway or Kroger and shoot rattle snake in the desert on weekend,go kiyaking,camping,hunting?
Look on the positive side,not everyone is sick or soon to die or crippled and disabled or turned into zombie.
May be by not talking about healthcare and illness,our cost will come down.
Go read a book,do some gardening or put on some of your favorite music and enjoy the day.
*
There is no 'Global savings glut',only wild horses and loose bankers.
posted on October 11, 2009 06:45:41 AM new
Well,Pizza hut is now complaining its sales is down .
Have you seen Walmart aisles,so much space is dedicated to frozen pizzas.
I once took a defensive driving course from a lady who has 3 daughters.
They never cook,every night they ordered pizzas from a local pizza outlet.
If they dont call,then the pizza outlet will call them and asked =is there anything wrong?How come no pizzas?
3 daughters grow up never learn how to cook or boil water or preheat oven!
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There is no 'Global savings glut',only wild horses and loose bankers.
[ edited by hwahwa on Oct 11, 2009 06:49 AM ]
posted on October 17, 2009 05:29:52 PM new
You dont need insurance if you can pay for it yourself.
Ever wonder what it would be if no one has insurance?
Then we will pay more attention to our medical bills and challenge the provider why some service/drug cost so much?
And do we really need all these tests,lab work and drug??
*
There is no 'Global savings glut',only wild horses and loose bankers.
