Tuesday, June 30, 2009


Sean sent me an article promoting it. Since I went to the trouble of refuting it, I might as well preach to my buddies the choir.

As our lawmakers struggle to come up with improvements to our failing health care system, we as concerned citizens have a responsibility to become more knowledgeable about this issue and to lend our voices and opinions to the debate. Since the United States is the ONLY industrialized nation without universal coverage, it may be helpful to compare the systems of other nations in determining what models might work here.

In 1787 America became the ONLY one of the aforementioned nations that didn’t have a king or emperor? Europe traded theirs for socialism.

The most “socialized” system is exemplified by Britain’s National Health Service. All citizens and legal residents are covered by the NHS. Ninety-five percent of NHS expenditures are financed through taxes, with the remaining 5% through user charges such as co-pays on prescription drugs, dental and vision services. Because there are no bills to collect or claims to review, administrative costs are very low. The government owns the hospitals and employs the doctors, but citizens can choose their doctors and where they receive care. Doctors are paid based on the number of patients they see and get additional financial rewards for keeping their patients healthy. As a result, Great Britain is the world leader in the area of preventive care.

Yes, and they keep them healthy by regulating their life choices.

To control costs, the NHS does not cover certain high cost treatments that are often ineffective. The most common complaints about the NHS involve waiting times—particularly for elective surgeries such as hip replacements.

These are not small questions. Once you cover everyone in a single system the only point of savings is the individual. Some bureaucrat gets to decide whether you get your transplant. Numerous stories of how people with treatable cancer die in Britain on waiting lists is no small matter either.

Britain spends only 8.3% of its GDP on health care, or an average of $2723 per person per year. The World Health Organization (WHO), which ranked the US 37th in the world in overall health care, ranked Britain’s system 18th. Other countries with systems similar to Britain’s include Spain (7th), Norway (11th), and Sweden (23rd).

By what criteria does WHO rank each country? I want to know how many people travel from the United States to each of these countries to be treated for rare diseases and vice versa. If their health care is the best then there would be no reason for them to come to America.

The health care systems of Germany, France and Japan are “insurance based” systems, similar to the US, but with several major differences. The first is that insurance is provided on a non-profit basis.

Why doesn’t the Left put their energy into a non-profit insurance company in this country? If what they say is true they could put private insurance out of business.

The second is that insurance is paid for by payroll deduction, similar to the way we pay for Social Security coverage. Another difference is that coverage is universal—no one can be excluded based on age, health status, etc. Unlike Britain, the government does not own or operate hospitals and doctors are in private practice or are employees of hospitals.

Well, if the model is Social Security then I know exactly how solvent the system is.

In Germany, workers and employers split the costs, with each contributing approximately 8% of payroll to 240 different “sickness funds”. Coverage includes dental, prescription drugs and long-term care. Germany spends 10.7% of GDP on health care, or an average of $3673 per citizen.

In Japan, employers and employees each contribute 4% of payroll to mandatory national health insurance plans. While taxes are lower, the Japanese pay more in deductibles and co-pays for inpatient and outpatient care (30% for outpatient care and 20% for inpatient hospitalizations.) The Japanese spend 8% of GDP, or an average of $2358 per citizen per year on health care. The WHO ranked Japan 10th and Germany 25th in overall health care.

Here we all pay the same amount for the same care as anyone else in our country. But In Japan you are punished for making more money.

The country ranked Number One in health care is France. The French system has the most comprehensive coverage in the world, with quality care, excellent choices of doctors and specialists, and with no waiting time. The French system taxes employers 13.1% of payroll and employees 0.75% of payroll.

Wrong! French Employers pay nothing. The 13.1% paid by employers is actually wages that the employee never sees. In what way are the choices excellent? And if waiting times in other countries are insignificant then why is it significant to mention that France doesn’t have them?

Most people (87%) have additional private for-profit supplemental insurance. Income taxes provide coverage for the elderly and unemployed. The French pay higher taxes, which they accept as a necessity. They spend 11.1% of GDP on health care and costs average $3374 per person per year.

Why is private insurance a necessity when they are already paying 13% in payroll taxes?

Canada’s single-payer system is often mischaracterized as “socialized” medicine. In actuality, a single-payer system is publicly funded with private delivery. Unlike Britain, the government does not own the hospitals or employ the doctors. Our Medicare system is an appropriate analogy to the Canadian system.

Our Medicare system is going broke like Canada.

In Canada, all insured people are required to be covered for all medically necessary hospital and physician care without co-pays or user fees. About 70% of total health care spending is financed by the public sector through income taxes, payroll taxes and sales taxes. Many Canadians obtain private insurance to cover prescription drugs, rehabilitation services, vision and dental care, which accounts for the remaining 30%. Canada spends 9.9% of GDP on health care, or $3678 per person.

Who decides what is necessary and are they rewarded for turning people down? How is it financed by the public sector? Do they own a football team or Exxon? No, they take the money from productive people. And on top of all those taxes they need private insurance anyway.

While Canadians complain of long waits for elective procedures and to see specialists, surveys show that a majority of Canadians are happy with their health care delivery system.

House slaves were pretty happy with their lives too in comparison.

Only about 40 developed countries in the world have established health care systems. In Africa, much of India, China and South America the rich who can afford to pay out-of-pocket get care and those who can’t afford to stay sick or die.

China is a communist country. Why doesn’t their socialism cover the best health care possible?

According to T.R. Reid, a Washington Post correspondent who has written extensively on health care issues, our fragmented national health care apparatus has elements of all these models. Our veteran’s health care system is like Britain’s, Medicare is like Canada’s, our employer-based insurance is like Germany’s or Japan’s (with the exception that most of the insurance industry in the US operates on a for-profit basis), while our 47+ million uninsured Americans might as well live in India.

Really, better in India? Health Insurance came about in the United States during World War II. Before that were people better off in India?

No country has the perfect health care system and perhaps none of these systems would be perfect for the United States. You should note however that, contrary to what the scary “Harry and Louise” type ads might imply, in ALL these systems, patients have a choice of doctors!

Wrong! You only have a choice of doctors in countries where it pays for the smartest most dedicated people to become doctors. That doesn’t happen in countries that control health care. Medicare is a year behind paying Sir Saunders his money from patients because they can be as late as they want.

The US spends a larger percentage of GDP (15.3%) and more per person ($6714) than any other country in the world—and unlike the US, the other 39 countries with established systems cover all of their citizens.

Anywhere else in government progressives will point to the amount of money spent and use it as justification for a superior system. Have you ever heard them brag that America’s education is better because we spend less money than Germany?

Whether we end up with a hybrid system like we have now or a system like the ones detailed above, we cannot solve our health care problems without finding a way to cover all Americans, without controlling administrative costs and without reducing wasteful, unnecessary and ineffective treatments and procedures.

Those efficiencies are impossible without Tort Reform which is not a part of this proposal. And we all know the government is a master at reducing administrative costs. Look at how little the Department of Education, Labor, Commerce etc cost.

1 comment:

Sir Saunders said...

This is great Tom, I left the Federal Government because I knew I could make more money as a private businessman where I would be rewarded for hardwork. All my colleagues laughed at me. Well over the past 4 years I've proved that I was right. Unfortunately, Obama may give them the last laugh as I may return working for the feds again whether I like it or not.

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