1) I remembered from Melanie's class that Medicare/Medicaid actually get pretty high satisfaction rates from consumers, but some of the arguments against government-run healthcare, are against Medicare and Medicaid. This is by Nick Kristof. It's called "Health Care That Works." Here's an excerpt about "socialized" firefighting.
"In truth, despite the deeply ingrained American conviction that government is bumbling when it is not evil, government intervention has been a step up in some areas from the private sector.
Until the mid-19th century, firefighting was left mostly to a mishmash of volunteer crews and private fire insurance companies. In New York City, according to accounts in The New York Times in the 1850s and 1860s, firefighting often descended into chaos, with drunkenness and looting.
So almost every country moved to what today’s health insurance lobbyists might label “socialized firefighting.” In effect, we have a single-payer system of public fire departments. "2) After yesterday's country presentation, I found this on NPR's website. It allows you to compare costs and some key indicators for the US, some European countries and Japan. I think all of the other countries listed have nearly or 100% coverage.
"Countries with governments and economies similar to the United States have come up with a variety of methods to make sure that all of their citizens receive health care. While residents in Europe and Japan may pay higher insurance premiums or taxes than Americans, in the end, when all costs are added up, Americans spend more money on health care per person with fewer people covered. (Data most recent available as of July 2008.)"
3) NPR also did a special comparative series on healthcare in many European countries, a few of which we covered yestereday: Germany, France and Great Britain.
Here is one I thought was particularly interesting, called Most Patients Happy with Germany Health Care.
"Mention European health care to an American, and it probably conjures up a negative stereotype — high taxes, long waiting lines, rationed care.
It's not that way in Germany. Very little tax money goes into the system. The lion's share comes, as in America, from premiums paid by workers and employers to insurance companies....
...Basing premiums on a percentage-of-salary means that the less people make, the less they have to pay. The more money they make, the more they pay. This principle is at the heart of the system. Germans call it "solidarity." The idea is that everybody's in it together, and nobody should be without health insurance....
...It's important to remember that the German government doesn't provide health care or finance it directly. It does regulate insurance companies closely — the nonprofits in the main system and the for-profits where Chris gets his coverage. So Chris' insurer can't raise his rates if he gets sick or jack up his premiums too much as he gets older. The government also requires insurers to keep costs down so things don't get too expensive.."
4) After yesterday's class, I am also curious for examples of rationing in the US. I believe rationing occurs here (to me, based on ability to pay), but couldn't come up with a good example, so I googled "does the US ration healthcare". This NYTimes article gives three ways in which the healthcare system here is rationed.
Here are the three main points, below:
"
There are three main ways that the health care system already imposes rationing on us. The first is the most counterintuitive, because it doesn’t involve denying medical care. It involves denying just about everything else.
1. The rapid rise in medical costs has put many employers in a tough spot. They have had to pay much higher insurance premiums, which have increased their labor costs. To make up for these increases, many have given meager pay raises.
Research by Katherine Baicker and Amitabh Chandra of Harvard has found that, on average, a 10 percent increase in health premiums leads to a 2.3 percent decline in inflation-adjusted pay. Victor Fuchs, a Stanford economist, and Ezekiel Emanuel, an oncologist now in the Obama administration, published an article in The Journal of the American Medical Association last year that nicely captured the tradeoff. When health costs have grown fastest over the last two decades, they wrote, wages have grown slowest, and vice versa.
2. The second kind of rationing involves the uninsured. The high cost of care means that some employers can’t afford to offer health insurance and still pay a competitive wage. Those high costs mean that individuals can’t buy insurance on their own.
The uninsured still receive some health care, obviously. But they get less care, and worse care, than they need. The Institute of Medicine has estimated that 18,000 people died in 2000 because they lacked insurance. By 2006, the number had risen to 22,000, according to the Urban Institute.
3. The final form of rationing is the one I described near the beginning of this column: the failure to provide certain types of care, even to people with health insurance. Doctors are generally not paid to do the blocking and tackling of medicine: collaboration, probing conversations with patients, small steps that avoid medical errors. Many doctors still do such things, out of professional pride. But the full medical system doesn’t do nearly enough.
That’s rationing — and it has real consequences.
In Australia, 81 percent of primary care doctors have set up a way for their patients to get after-hours care, according to the Commonwealth Fund. In the United States, only 40 percent have. Over all, the survival rates for many diseases in this country are no better than they are in countries that spend far less on health care. People here are less likely to have long-term survival after colorectal cancer, childhood leukemia or a kidney transplant than they are in Canada — that bastion of rationing.
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In my opinion, much of the healthcare debate is stifled by a fear of words (NPR article on the use of fear tactics in the debate). I wonder what the debate would look like without the words "socialized" and "rationing," and I'm curious to know what people think are the buzzwords the left uses.
I realize that the articles I posted probably make my view on healthcare pretty obvious, and that in the healthcare debate, it is easy to selectively hear one side of the debate (I'm guilty). But, I think this is an opportunity to really try to see the debate from many sides. I'm excited to learn more and gain an understanding for different viewpoints so if you have a different perspective, share it. Happy long weekend!
P.S. A slightly different take on rationing in the US--by insurance and ability to pay
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