Oh.....I seee.....this thread isn't really about universal health care, it's about solar power. Why didn't you say so?
In case someone might be misled into thinking that this thread is about Universal Health Care I thought I'd post the following.
Europe versus the U.S. - a health-care comparison
By Stephanie Hittle
For Health Care Today
Health care comes in different packages, depending where and how that health care is delivered.
How does health care in the United States compare with other countries such as England and Germany? What are the pros and cons of various forms of health-care systems? Which system is best?
"There is no perfect system. You can't make everyone happy. People in Sweden have notoriously good health outcomes, and not everybody in Sweden is happy with their health care," said Rachel Irwin, a Centerville native and graduate student at the London School of Economics in London, England, where she studies international health policy. She is also a consultant on evaluating effectiveness in nonprofit organizations.
Some health-care programs work better than others, however, and the United States has multiple problems, according to Irwin, who has studied the systems of European countries and the United States.
Irwin said health-care delivery systems in developed nations are categorized by how they are funded, which is usually in one of three ways ?- through taxation, social insurance or private insurance. Third world countries rarely have organized systems of health-care delivery and often rely on NGOs ?- nongovernment organizations (charities) to provide health care to their citizens. Corporations with plants in those countries often provide their own health care to their own employees.
"Social health insurance is where the employer and, usually the employee, make contributions based on their abilities to pay," said Irwin, who added that social health insurance is often erroneously referred to as socialized medicine. "It has nothing to do with a political ideology."
In social health insurance, monies go into a sickness fund, usually based on occupation or geographical location or both, according to Irwin. This sickness fund functions like an insurance company, but typically is not for profit or is allowed profit only on supplemental insurance. People in more populated areas usually have more options for providers of health care and therefore more choices, compared with someone in a rural area, where availability may be an issue and the sickness fund may have geographic boundaries.
"The German social health system started as tradesmen pooling their funds to help one another in times of sickness during medieval times," Irwin said. For example, she said Germany has a Sailor's Fund, originally organized around the needs of that occupation. Sickness funds are usually self-governing; although the government influences the contribution rates.
Unlike the U.S. private insurance system, the German sickness funds are not based on risk, and everyone is covered.
"It is compulsory for the whole population to be in a fund. Everyone is required to be in it except for the top 10 percent of the highest income earners in the country," said Irwin, adding that those persons can fund their own health care. The government puts in monies for persons who are unemployed. The government also handles disability payments in times when a person can't work.
Irwin said most recipients of this system are happy with it.
Tax-financed health care, often referred to as nationalized health care, is the delivery system of choice for United Kingdom and Scandinavian countries. How the tax is applied ?- through income and property or through sales tax, differs depending on the country.
Irwin acknowledged that in this type of system wait times for elective surgery can be longer than in the United States.
On the plus side, tax-financed health care covers everyone and the quality of care is usually good, according to Irwin.
The United States health-care system is considered private, but Irwin points out that with 47 percent of health-care funding coming from the government, the term "private" is misleading.
"Forty-seven percent of health-care dollars are spent on Medicaid, Medicare and public hospitals," Irwin said.
The other touted "plus" of private insurance is the concept of risk. Insurance companies use formularies to calculate risk of those they insure.
"It is hard to calculate probability in health care," said Irwin, who stressed that insuring the human body is not the same as insuring a car. The latter is based on static, objective criteria. The former is not. "Health has a lot of unknowns."
Irwin also pointed out that those people who need insurance the most are precluded from getting it due to pre-existing condition clauses in insurance policies.
Then there are the problems with cost. Irwin said that in European countries the health-care spending per capita are from $2,500 to $4,000. In the United States, it is $6,000.
"That is a huge jump," Irwin said. "We are throwing money at health care but still not getting anywhere."
"The argument that people will become healthier because of risk doesn't hold up. Look at Americans," Irwin said. "Americans are among the most overweight populations in the world."
Americans also lead Europe in heart disease (nearly double), high blood pressure, stroke and diabetes as well as ten other major medical concerns.
And not everyone is covered.
Irwin also has a bachelor's degree in medical anthropology and German studies from Case Western University in Cleveland and a master's degree in medical anthropology from Oxford University in Oxford, England. Medical anthropology is the study of health within various cultural contexts. She stressed that choices in how health care is funded and delivered are based on social, historical and cultural factors.
"In Denmark," Irwin said, "there is a lot of social cohesion ... and wanting to help one's fellow Dane. They see someone who is sick or poor and they want to help them."
Irwin can be reached at
[email protected].
Stephanie Hittle is a licensed professional clinical counselor with South Suburban Mental Health Group in Centerville.
