Health Care Non-American Style

swimpy :
a thoughful article imo .

the last two sentences also sum up my thoughts on the subject (as i wrote earlier) :



we've had numerous "royal commissions" and think-tanks that have grappled with the problem ... plenty of good suggestions were put forward ... but no government has been able(or willing) to introduce major changes/improvements .
at a certain point the sysstem is going to spin out of control imo .
hbg

I think what is needed is a basic system that provides core coverage only. That is where that cost number rose so much in the MA plan as mentioned in the article. They started out with a basic plan and then tacked on more and more at the request of a number of special interests. The price quickly jumped and it became a no-go. When they went back with most of the add-ons stripped out the prices came back down to a realistic number.

What would you consider to be basic?

I would consider basic health insurance as hospital coverage only,
with a yearly preventative check-up included.

One option would be an accrued system where you can carry over
a certain dollar amount, if not all, into the next year if you have no claims
for that fiscal year.

Or your premium starts out with 100 % and if you have not had any major claims aside from a yearly check-up, the premium will be reduced for
the following year, and the year thereafter. So in essence, in your younger
years when you're healthy and active, you pay a higher premium that is reduced over the years to 20 % from what you originally paid.

There are many options actually, but the key problem is with insurance providers, in my opinion. We have some 30 private providers (mostly HMOs) here in southern California. Their premiums are high, and they pressure physicians into capitation fees while their profits soar.

I think my idea would be about the same. Some sort of "Catastrophic care" coupled with routine annual physicals (maybe every other year for those under age 30? I dunno what the recommendation of Med Professionals is there) and the annual OB/GYN stuff for the wimmins as well as prenatal and neonatal care.

I do think there should be a co-pay for care. It could be waived for those below a certain income level (Federal poverty level maybe?) and then scale up from there.

i think one the problems health insurance plans (private and government-sponsored) are facing is the large increase in seniors and how to meet their increasing requirements for medical care - and i'm not even talking about assisited living , senior homes etc , just the increased necessity to provide "normal" health care as people get older .
until just a few years ago , our demands on the health providers were pretty minimal and we have so far still few demands - mrs h had cataract surgery .

but when we look at friends and neighbours in their 70's and 80's , most of whom live pretty active lives , we see their demands for increased services :
diabetes treatment ,
kidney dialysis ,
hip and knee replacements ,
heart surgery ,
stem implants ,
eye surgery ...

and some are now in the early stages of alzheimer's and parkinson's disease - but still staying at home .

with proper care most of these people will live long lives - as long as there are adequate funds - private or government .
in a private plan huge reserves would have to be set aside to cover these costs.

certainly sounds like a good idea to talk about it .
pity the politician who may have to grapple with restricting some of the medical care !
hbg

Well, hamburger, that's why it is so important to have a healthcare reform,
as the masses of baby boomers age and are in more need of medical
attention.

I think Samuelson's column answers many of the questions asked on this thread.

Here is the entire column:



Hiding Health Care's Costs

By Robert J. Samuelson
Wednesday, January 31, 2007; Page A15

We are awash in health-care proposals. President Bush has one. So does California Gov. Arnold Schwarzenegger. Democratic Sen. Ron Wyden has a plan, as does a coalition led by Families USA (a liberal advocacy group) and America's Health Insurance Plans (a trade group). To some extent, all these plans and others aim to provide insurance to the estimated 47 million Americans who lack it -- a situation widely deplored as a national disgrace. But the real significance of all these proposals, I submit, lies elsewhere.

For decades, Americans have treated health care as if it exists in a separate economic and political world: When people need care, they should get it; costs should remain out of sight. About 60 percent of Americans receive insurance through their employers; to most workers, the full costs are unknown. The 65-and-older population and many poor people receive government insurance. Except for modest Medicare premiums and payroll taxes, costs are largely buried in federal and state budgets.


Syndicate/Subscribe
Select Method (may require registration) XML (raw feed)BloglinesGoogle Homepage/Google ReaderMy AOLMy MSNMy YahooNetvibesNewsburstNewsGatorPluckRojo

The World Bank,
Stuck In the Mud
» Sebastian Mallaby | There is no moral clarity emanating from the World Bank right now. Instead, there is demoralizing scandal.
Robinson: Why Imus Had to Go
Ignatius: Bush's Power Outage
Dionne: Saying No to Fox


OPINIONS: Think Tank Town
On Faith | PostGlobal

Who's Blogging?
Read what bloggers are saying about this article.
Flashpoint | The Unpredictable Union of Pragmatism, Idealism, and Cynicism
RollingDoughnut.com
Trifles from Anderson, Indiana


Full List of Blogs (18 links) »


Most Blogged About Articles
On washingtonpost.com | On the web


Save & Share Article What's This?

DiggGoogle
del.icio.usYahoo!
RedditFacebook

It is this segregation of health care from everything else that is now crumbling -- and the various health proposals are just one sign. We see others all the time. For example, even with employer-provided insurance, workers' average monthly premiums (which cover only part of the costs) have skyrocketed. From 1999 to 2006, they doubled, from $129 to $248.

Look at Massachusetts. Last year, then-Gov. Mitt Romney made headlines by signing legislation to cover all the state's uninsured. The law required that those whose income exceeded three times the federal poverty line buy "affordable" insurance (those with incomes below that threshold would be subsidized on a sliding scale). Romney suggested that annual premiums for a single worker might total $2,400. But when insurance companies recently provided real estimates, the cost was much higher: $4,560. Is it sensible policy to force workers making $30,000 -- about triple the poverty line -- to spend almost a sixth of their pretax income on health insurance, as opposed to food, rent or transportation? Good question.

The hard questions won't sit still, because health care (now a sixth of the economy, up from one-eleventh in 1980) is too big to be hidden. Myths abound. Contrary to conventional wisdom, the doubling of premiums for employer-provided coverage doesn't mean companies shifted a greater share of costs to workers. In both 1999 and 2006, premiums covered 27 percent of costs, says Paul Fronstin of the Employee Benefit Research Institute. It's simply the rapid rise in total health spending that's depressed workers' take-home pay.

One myth about the uninsured is that, because they're heavy users of emergency-room services, providing them with insurance (and regular care) would actually lower their costs. This may be true for some -- but not most. The trouble is that the uninsured don't really use emergency rooms heavily. A study in the journal Health Affairs finds that their use is similar to that of people with private insurance -- and half that of people with Medicaid. Extending insurance to all the uninsured would be costly, because they would get more and (presumably) better care. John Sheils of the Lewin Group estimates the annual cost of their care would rise 75 percent, to $145 billion.

Our health-care system will inevitably combine government regulation and private enterprise. But what should the mix be? How important is health care compared with other public and private goals? Will an expanding health-care sector spur the economy -- or, through high taxes and insurance premiums, retard it? We have refused to have this debate for obvious reasons. It makes us queasy, because it pits moral imperatives (including the right to live) against coldhearted economics. A case in point: A friend of mine recently had a near-death experience; he survived only because he had superb medical care.

I don't intend to examine -- at least now -- all the new proposals. Some would do better at some goals (say, protecting the poor) than at others (say, controlling costs). But the Bush proposal does have one huge virtue: It exposes health-care costs to the broad public. By not taxing employer-paid insurance, the government now provides a huge invisible subsidy to workers. Bush wouldn't end the subsidy, but by modifying it with specific deductions for insurance ($15,000 for families, $7,500 for singles), he would force most workers to see the costs. By contrast, some other proposals disguise their costs. Schwarzenegger's plan shifts costs to the federal government, doctors and hospitals. It's clever, but it perpetuates the illusion that health care is cheap.

However our health system evolves, Americans need to come to a more realistic understanding of its limits. Underestimating its costs and exaggerating its benefits guarantee disappointment. If the present outpouring of proposals signals a start of our needed debate, it is long overdue.

I don't see where he answered any of the questions raised here.

Orilione, Where are you from?

Where Am I from?

The center of the USA. That is why I languish without the splendid health care found in other countries. That is why I was able to call the Mayo Clinic two years ago and make an appointment in ONE WEEK with some of the best doctors in the world to diagnose and treat a stomach ailment successfully and that is why I want absolutely no changes made to my Health Insurance. I want to preserve my freedom to obtain the best care possible.

Anyone who has ever visited the Mayo Clinic in Rochester, Minnesota or has been a patient there knows that the Clinic is host to thousands of sick people seeking help from every country in the world--especially Canada.

OK. Thanks.

CJ, You introduce a very good topic for all of us whether we live in the US or elsewhere. Universal health care has its pros and cons, but it's needed in the US - like yesterday.

I've seen articles in the past where we spend too much on administrative costs in the US for health care. That needs to change.

There are no simple solutions for health care when there are so many facets of funding for it; government (both state and federal), company sponsored (some fully paid, while others have co-pays), and private premiums. We have enough people in this country who understands all the nuances of the different plans who can organize it into a cohesive system to cover all Americans. It's ludicrous that the richest country on this planet still has some 47 million people without health insurance.

This topic should be the primary one for the next presidential election. We've already waited too long.

Japan, which has universal health care, has more CAT, MRI, etc., equipment than we do.

A simple solution would probably be to extend Medicare, with drug benefits, to everyone. It is at least five times for cost efficient than any private plan.

That would be an option, Advocat, actually a good one.

Instead of paying high premiums to healthcare providers, we only
pay into Medicare and receive the same benefits as the 65+ crowd does
now. And if needed, one could take out a supplemental health insurance.

Problem solved!

It was Swimpy who thought of the topic, cicerone
But you and I will see what Schwarzenegger has in mind for our
California universal health insurance.

Medicare has its own problems that need to be addressed before we expand it. http://www.ncpa.org/abo/quarterly/20044th/clip/pdf/hc-20041220lat.pdf

Your claims of Medicare's efficencies have been debunked elsewhere here on A2K. It is no where near 5 times more efficent - even by the evidence you've posted.

As for CT and MRI scanners:

"During the past decade, there has been a rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In 2000, Japan had by far the highest number of CT and MRI scanners per capita, with 84 CTscanners per million population (chart 2.14) and 23 MRI units (chart 2.13). The average number of CT and MRI scanners in OECD countries was 17.7 and 6.5 respectively. The rapid increase in the number of MRIscanners in Japan has been attributed at least partly to the lack of any formal assessment of efficiency or effectiveness before decisions were made to purchase MRIs."

http://www.oecd.org/dataoecd/20/5/16502622.pdf

Great. Just what no one wants. Throw them out there without looking at whether they are necessary or effective.

I have not seen anyone successfully debunk the efficiency of Medicare, but have seen the opposite. Medicare is not perfect, but what is? We need to get away from our present so-called system (mess) ASAP -- it dragging our country down.